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Accepted Paper:
The performativity of boundary work and the demarcation of ethical governance amongst clinicians who provide autologous stem cell therapies in Australia
Casimir MacGregor
(BRANZ Victoria University of Wellington)
Alan Petersen
Megan Munsie
(The University of Melbourne )
Claire Tanner
(Monash)
Within Australia there are a small, but growing number of doctors offering unproven therapies using the patient's own stem cells for incurable diseases, sports injuries, cosmetic and anti-ageing purposes. Under current Australian regulations, such autologous interventions are viewed as a 'medical procedure' and outside the remit of the Australian regulation body with oversight for the manufacturing and marketing of therapeutic goods - the Therapeutic Goods Administration. The sale of autologous stem cell treatments - often for many thousands of dollars - is viewed by many clinicians and scientists as challenging professional ethical standards due to the experimental nature of such treatments, and they have called for urgent amendments of Australian regulations to restrict such practices. Others believe Australian doctors have a right to provide this treatment, and propose a self-regulation model to provide greater community safeguards. Based upon in-depth interviews with doctors who provide autologous stem cell therapies and other stakeholders in the field, this paper examines the tension over the ethical governance of autologous stem cell therapies and the performative boundary work utilised by doctors in their professional ideologies and practices to create governance within this emerging industry.