Camporesi S, McNamee MJ (2013) ‘Is there a role for genetic testing in sports?’ Encyclopedia of Life Sciences DOI: 10.1002/9780470015902.a0024203
The last fifteen years have witnessed a boom of genetic tests for sport performance. They relate both the ability to predict athletes at higher risks for specific injuries, and to the ability to predict athletic talent. They raise scientific and ethical issues related to confidentiality, conflict of interest of the sports physician, informed consent in children, and possibly infringement on the athlete’s autonomy. In this paper we distinguish here genetic tests for injury prevention in four cases: (i) concussion-related trauma brain injuries; (ii) sudden-cardiac arrest related conditions; (iii) over-exertion complications related to the sickle-cell anemia trait; (iv) Achilles tendinopathies and anterior crucial ligament ruptures, and for athletic performance prediction in children. We argue that while the former kind of genetic tests have utility, with the bounds of specified limitations, the latter is both ethically and scientifically problematic. The paper can be accessed here.
In this paper I analyse the use of DTC genetic tests, sometimes coupled with more traditional methods of ‘talent scouting’, to assess a child’s predisposition to athletic performance. I first discuss the scientific evidence at the basis of these tests, and the parental decision in terms of education, and of investing in the children’s future, taken on the basis of the results of the tests. I then discuss how these parental practices impact on the children’s right to an open future, and on their developing sense of autonomy. I also consider the meaning and role of sports in childhood, and conclude that the use of DTC genetic tests to measure children’s athletic potential should be seen as a ‘wake up’ call for other problematic parental attitudes aimed at scouting and developing children’s talent.
Camporesi S, McNamee MJ (2012) ‘Gene Transfer for Pain: A tool to cope with the intractable, or an unethical endurance-enhancing technology?’ In this paper, published for Genomics, Science & Policy Journal, we address the question whether it can be ethically justifiable to seek gene transfer to raise one’s own tolerance to pain in a therapeutic and in an elite sports context. As a case study we analyse a currently recruiting Phase 1 study that seeks to transfer Vascular Endothelial Growth Factor to treat pain in patients with peripheral artery disease, but that could plausibly be applied also in an elite sports context. We presented this paper at the International Association for Philosophy of Sport, Porto, Sept 12-15, 2012. You can read the full paper free of charge here.
Karkazis K, Jordan-Young R, Davis G, Camporesi S. (2012) Out of bounds? A critique of the new policies on hyperandrogenism in elite female athletes, Am Journal Bioethics; 12(7):3-16. In this paper co-authored with Katrina Karkazis (Department of Biomedical Ethics, Stanford), Rebecca Jordan-Young (Barnard College, NYC), and Georgiann Davis, we analyse and question the new policies on the eligibility of female athletes with hyper-androgenism to compete in the female category, and find them flawed on the basis of three grounds: we question the new policies on three grounds: 1) underlying scientific assumptions; 2) the policy-making process; and 3) fairness for female athletes. Consequently we argue that they should be withdrawn. You can read the KCL press release about this paper here.
Camporesi S, Mameli M. (2012) The context of clinical research and its ethical relevance: The COMPAS trial as a case study. Am Journal Bioethics, 12(1):39-40. This short paper is an open-peer commentary (OPC) to Dave Wendler‘s new justification of paediatric research without therapeutic benefits. Wendler argues that pediatric clinical research that offers no therapeutic benefits to the participants can be justified on the basis that participating in clinical research qualifies as contributing to a valuable project. Matteo Mameli and I disagree and argue that Wendler’s argument is unsatisfactory in that it fails to consider the context of clinical research, i.e. the conditions in which participants find themselves and, more specifically, the kind of access to health care that they have. In our OPC we provide a concrete example to our arguments, by focusing on the recent COMPAS-Synflorix trial (Argentina, 2008).
Camporesi S. Maugeri P (2011) ‘Genetic enhancement in sports and how to reason private rationalities out into the public arena‘, Cambridge Quarterly of Healthcare Ethics, 20(2):248-57. This paper is part of a special issue of the CQHE devoted to the analysis of methodologies in philosophical bioethics. In this paper Paolo Maugeri and I review Matti Häyry’s book Rationality and the Genetic Challenge: Making People Better? and apply his ‘non-confrontational thesis’ (according to which the role of philosophy in assessing the new genetic challenges must be that of a ‘polite bystander’, aimed only at assessing the internal consistency of each ethical framework and not the superiority of one on another) to the challenge posed by genetic enhancement and gene doping in professional sports.
Camporesi S, Bottalico B, Zamboni G. (2011). Can we finally ‘see’ Pain?: Brain imaging techniques and implications for the law. J Consciousness Studies, 18(9-10):257-276. The paper is part of a special issue of the journal entirely devoted to ‘pain’ which includes many other contributions spanning from philosophy, biology, psychology, neurology, physiology, ethics, and the law. In this contribution we assess the implications of brain imaging techniques – in particular, functional MRI- to make pain visible, measurable and, to some degree, verifiable, and therefore to serve as a new kind of scientific evidence in the numerous legal claims of chronic pain where the jury has to assess the truthfulness of the claimants.
Maddock C, Camporesi S, Lewis I, et al. (2011) Online information as a decision making aid for cancer patients: Recommendations from the Eurocancercoms project, Eur J Cancer, doi:10.1016/j.ejca.2011.08.018. This paper is the result of a pan-European survey conducted under the auspices of the FP7 Eurocancercoms project during the period September 2010-March 2011. The survey was designed to broaden public policy understanding of patients’ specific needs when seeking online cancer information and aimed to identify gaps in the online cancer information provision across Europe. In this paper we describe the methodology and main findings of the Tenovus survey, and draw some recommendations on the use of online information as a decision making aid for cancer patients and their families.
Fojo T, Siderov J, Williamson S, Camporesi S, McVie JG, et al (2011) Delivering affordable cancer care in high-income countries. Lancet Oncol;12(10):933-80. The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? In this paper we address the barriers and solutions to deliverin..g affordable cancer care and identify several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies, and the lack of suitable clinical research and integrated health economic studies.
Pritchard-Jones K, Lewison G, Camporesi S, et al. (2011) The state of research into children with cancer across Europe: new policies for a new decade, ecancermedicalscience; 5(210). DOI: 10.3332/ecancer.2011.210. Overcoming childhood cancers is critically dependent on the state of research. As part of the EU funded Eurocancercoms project to study and integrate cancer communications across Europe we have carried out new research into the state of research in childhood cancers. Over a 6-week period in 2010 a survey was conducted through the offices of SIOPE (the European Society of Paediatric Oncology) of key opinion leaders across Europe to determine their views on the state of paediatric oncology at both national and European level through a framed questionnaire. The responses are outlined in this report and form the basis for spelling out new policies for paediatric oncology in Europe aimed at increased harmonisation, consistent guidelines and at the establishment of a common platform for translational clinical trials.
Camporesi S. (2010): ‘Choosing deafness with pre-implantation genetic diagnosis: an ethical way to carry on a cultural bloodline?’ Cambridge Quarterly of Healthcare Ethics 19(1): 86-96. While screening and choosing for a ‘disability’ remained a theoretical possibility only a decade ago, it has now become reality. In 2006, Susannah Baruch and colleagues at John Hopkins University published a survey of 190 American preimplantation genetic diagnosis (PGD) clinics, and found that 3% reported having the intentional use of PGD “to select an embryo for the presence of a disability” (deafness or dwarfism). In this paper I analyse the real case of genetically deaf parents seeking in vitro fertilization and PGD in the US to choose ‘children like themselves’, i.e. to choose to implant an embryo carrying the mutation for genetic based deafness.
Camporesi S, Maugeri P. (2010): ‘Caster Semenya: sport, categories and the creative role of ethics’, J Med Ethics 2010;36:378-379 . In this paper co-authored with Paolo Maugeri we address the Caster Semenya’s controversial case. Caster, a South African runner of 18-year-old at that time, won the 800-metre track running title at the Berlin World Athletics Championships in 2009. Her medal was shortly afterwards revoked on the basis of a dispute on her gender initiated by the International Association of Athletics Federations (IAAF). At the time of writing the results of her gender tests were still not have been made public (nor have they later been disclosed), but in this paper we argue that a scientific or medical test alone cannot possibly offer uncontroversial answers regarding Caster’s gender, and her eligibility to compete with female athletes. The question that needs to be answered is whether Caster has an ‘unfair advantage’, and ethics and law need to enter into the discussion.
Camporesi S. (2008): ‘Oscar Pistorius, enhancement and post-humans’ J of Medical Ethics 34(9): 639. Oscar Pistorius is a South-african professional athlete who was born without fibulas and had both legs amputated below the knee when he was 11 months old, and who runs with the aid of carbon-fibre artificial limbs. In this short editorial I argue in favour of Oscar Pistorius running with able-bodied athletes : ”His case is a snap-shot into the future of sport. As our concept of what is ‘natural” depends on what we are used to, and evolves with our society and culture, so does our concept of “purity” of sport, and our concept of how an Olympics athlete should look like”.
Camporesi S. and Boniolo, G. (2008): ‘Fearing a non existing Minotaur? The ethical challenges of research on cytoplasmic hybrid embryos’ J Medical Ethics, 34: 821-825. In this paper we address the controversial pronouncement of the UK’s Human Embryology and Fertilisation Authority of September 2007 on the permissibility research on the ethical challenges of research on human-animal cytoplasmic hybrid embryos, or ‘cybrids’.
Camporesi S. (2007): The context of embryonic development and its ethical relevance, Biotechnol J, 2(9):1147-53. My very first paper…Re-reading it now it I found it quite naive (but that is a general reaction to reading old papers I guess) but I am affectionately attached to it. Anyhow, in this review I discuss -and try to dispell- ten frequently used arguments against research on human embryos.