Launching invasive, first-in-human trials against Parkinson's disease: ethical considerations

Mov Disord. 2009 Oct 15;24(13):1893-901. doi: 10.1002/mds.22712.


The decision to initiate invasive, first-in-human trials involving Parkinson's disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable risk-benefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We close with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Clinical Protocols*
  • Clinical Trials as Topic / ethics*
  • Clinical Trials as Topic / methods*
  • Humans
  • Neurosurgical Procedures / ethics
  • Neurosurgical Procedures / methods
  • Parkinson Disease / therapy*
  • Risk Assessment / ethics
  • Risk Assessment / methods
  • Risk Factors
  • Treatment Outcome