Questões de Vestibular FAG 2018 para Vestibular, Primeiro Semestre - Medicina

Brazilian courts tussle over unproven cancer treatment

Patients demand access to compound despite lack of clinical testing. A court in the Brazilian state of São Paulo has cut off distribution of a compound that is hailed by some as a miracle cancer cure — even though it has never been formally tested in humans. On 11 November, to the relief of many cancer researchers, a state court overturned earlier court orders that had obliged the nation’s largest university to provide the compound to hundreds of people with terminal cancer.

The compound, phosphoethanolamine, has been shown to kill tumor cells only in lab dishes and in mice (A. K. Ferreira et al. Anticancer Res. 32, 95–104; 2012). Drugs that seem promising in lab and animal studies have a notoriously high failure rate in human trials. Despite this, some chemists at the University of São Paulo’s campus in São Carlos have manufactured the compound for years and distributed it to people with cancer. A few of those patients have claimed remarkable recoveries, perpetuating the compound’s reputation as a miracle cure.

The Brazilian constitution guarantees universal access to health care, and it is common in Brazil for patients to turn to the courts to access drugs that the state healthcare system does not dispense because of their cost. But phosphoethanolamine presents a different situation because it is not really a ‘drug’ at all. It is not approved by Brazil’s National Health Surveillance Agency.

Those who argue that people who are terminally ill have a right to try experimental medicines saw a decision in favor of a patient in October 2015 as a significant victory. But to the university administration, drug regulators and cancer researchers, it showed blatant disregard for the basic scientific principle that a drug should be demonstrated to be safe and effective before being given to patients outside of a clinical trial.

Bilingual Education for the 21st Century

Bilingual education in the 21st century must face the complexity brought about by the freer movement of people, services, and goods that characterizes our more globalized and technological world. In the second half of the 20th century, bilingual education grew around the world as a way to educate children who didn't speak the state's language or, in some cases, to recapture the heritage language of a group. This in itself was an innovation over the use of bilingual education only to educate the children of the elite.

In the 21st century, however, the complex and dynamic links created by technology and globalized markets, coupled with the importance of English and other “big” languages, challenge our old conceptions of bilingual education. UNESCO in 1953 declared that it was axiomatic that the child's native language be used to teach children to read, but basic literacy, even in one's own language, is insufficient to be a world citizen in the 21st century.

It has been predicted that by 2050, English will be accompanied by Chinese, Arabic, Spanish and Urdu, as the world's big languages, ordered not only with English at the top as it has been up to now, but with an increasing role for the other four “big” languages. Countries throughout the world are providing options to their children to be schooled in two or more languages. The European Union, for example, has recently adopted a policy of “Mother Tongue + 2” encouraging schools throughout the EU to develop children's trilingual proficiency. For those purposes, a model of teaching is being promoted that encourages the use of the languages other than the child's mother tongue in subject instruction. Ofelia Garcia is Professor of Bilingual Education at Teachers College, Columbia University.