Ethical and regulatory challenges with autologous adult stem cells:A comparative review of international regulations

Cell and tissue-based products, such as autologous adult stem cells, are being prescribed by physicians across the world for diseases and illnesses that they have neither been approved for or been demonstrated as safe and effective in formal clinical trials. These doctors often form part of informal transnational networks that exploit differences and similarities in the regulatory systems across geographical contexts. In this paper, we examine the regulatory infrastructure of five geographically diverse but socio-economically comparable countries with the aim of identifying similarities and differences in how these products are regulated and governed within clinical contexts. We find that while there are many subtle technical differences in how these regulations are implemented, they are sufficiently similar that it is difficult to explain why these practices appear more prevalent in some countries and not in others. We conclude with suggestions for how international governance frameworks might be improved to discourage the exploitation of vulnerable patient populations while enabling innovation in the clinical application of cellular therapies

Pastoral care for shame-based perfectionism

While perfectionism has been associated with guilt dynamics, the form of perfectionism that is most frequently discussed by psychologists is connected to self-condemnation for perceived failures to reach the high standard set for personal achievement. There is therefore a strong link between perfectionism and inferiority shame. Psychotherapists have given quite a bit of attention to shame-based perfectionism; it has been largely neglected by pastoral psychologists. Three approaches to the pastoral care of shame-based perfectionism are developed. The first approach is based in cognitive therapy. It is argued that perfectionism is grounded in a faulty core belief about the self—namely, “I am what I achieve.” The second method makes use of strategies developed by John Bradshaw for accepting and affirming all one’s sub-selves. Bradshaw’s approach is critiqued, however, for the way in which shame-based and guilt-based perfectionism are confused. The third method is a modification and adaptation of Heinz Kohut’s strategy of “mirroring” (empathy, admiration, and approval) that he developed for use in work with clients with narcissistic personality disorder