Researchers found numerous campaigns raising funds to pay for
non-proven therapies, according to the study published in JAMA.
"Large sums of money are being raised for dangerous, fringe,
known-to-be ineffective interventions with no accountability on the
part of the fundraisers or the providers of what are often hugely
expensive, useless, or even harmful procedures," said coauthor Art
Caplan, medical ethicist at the NYU School of Medicine in New York
City.
To take a closer look at the issue, Caplan and colleagues focused on
the largest crowdfunding site, GoFundMe, and three other well
trafficked sites that permitted medical fund raising: YouCaring,
CrowdRise and FundRazr. They concentrated on five treatments that
are scientifically unsupported or experimental or potentially
dangerous: homeopathy or naturopathy for cancer; hyperbaric oxygen
therapy for brain injury; stem cell therapy for brain and spinal
cord injury; and long-term antibiotic therapy for chronic Lyme
disease.
The researchers identified all existing fundraising campaigns posted
from November 1, 2015 to December 11, 2017 using search terms
relating to the therapies of interest. Out of 1,636 campaigns the
researchers identified, 1,059 mentioned the intention to use the
funds raised for one of the five treatments. These campaigns were
seeking a total of more than $27 million. The vast majority - 98
percent of the campaigns - were on GoFundMe.
In the end, a total of $6.8 million, or roughly 25 percent of what
was requested, was raised by these crowdfunding campaigns. The
largest proportion, nearly $3.5 million, was raised in 474 campaigns
collecting funds for homeopathic or naturopathic cancer treatments.
The 190 campaigns to raise money for hyperbaric oxygen therapy for
brain injury achieved nearly $785,500 of the $4 million sought.
Campaigns for stem cell therapy for brain injury, which sought
nearly $6 million, raised $1.25 million, and campaigns for stem cell
therapy for spinal cord injury, which sought $2.6 million, raised
$590,446. Campaigns to raise money for long-term antibiotic therapy
for chronic Lyme sought roughly $2.16 million and raised roughly
$690,000.
The dangers of such campaigns, Caplan said, lie in the lack of
regulation.
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"Generous donors are being ripped off and desperate patients and
families are being exploited by charlatans, quacks and dubious
providers," he said. "Crowdsourcing sites in health care should
insist on standard campaigns that say where money goes, what happens
if all the money sought is not raised, what the return policy is and
that something should be posted on the outcome of the intervention
if it is obtained."
While the study opens the discussion on an important topic, it
muddies the issue by mixing clearly unproven therapies - such as
homeopathy to treat cancer - with treatments that are being tested
in clinical trials, such as stem cell therapy for spinal cord
injuries and hyperbaric oxygen for brain injury, said Lisa Parker,
director of the Center for Bioethics and Health Law at the
University of Pittsburgh.
Nevertheless, there are two obvious downsides to crowdfunding for
these treatments, Parker said. First, patients may harm their health
if they use crowdfunded money to pay for therapies that are proven
not to work and foregoing proven treatments. Second, if they use
crowdfunded money to pay for experimental therapies outside of
clinical trials, that denies society the information it would get
were the patient a part of the clinical trial.
The findings weren't a surprise to Dr. Jeffrey Kahn, director of the
Johns Hopkins Berman Institute of Bioethics. "It's the predictable
consequence of the ability for people to reach out to the public
without intermediaries, trusted or untrusted," Kahn said. "It's a
way to go around those intermediaries, whether they are physicians
or insurance companies, to obtain what they want to achieve."
But intermediaries "serve a purpose," Kahn said. "In this case it's
protecting people from spending their money on things that don't
work or may harm them. This is not a new problem. Remember laetrile
and people going to Mexico to get it to treat cancer? It was an
extract from apricot pits that was found not only to be not helpful
but also to be harmful."
SOURCE: http://bit.ly/2PQEVqB JAMA, online October 23, 2018.
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