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To an adolescent who dreams of dominating the basketball court, synthetic human growth hormone may look like a godsend. To biotechnology watchdog Jeremy Rifkin, it has a more sinister aspect. The 5-foot-7 activist doesn’t view short stature as a medical problem, and he’s appalled that the US government is sponsoring a 10-year study to see whether the treatment will make healthy children taller. In a new petition to the National Institute of Health, Rifkin and his Washington-based Foundation on Economic Trends charge that the study violates federal rules restricting medical experiments on children. No one expects the petition to shut down the study, but it has rekindled a long-simmering debate over what makes a difference a defect. Synthetic human growth hormone was approved in 1985 as a treatment for kids who don’t produce the substance naturally. The manufacturers would like to find a large clientele. The disputed NIH trial, now in its second year, is designed to see what effect the treatment will have on kids with normal hormone levels, but who fall at the lowest end of the height curve. Half of the 80 participants get injections of synthetic growth hormone three times a week. The others get dummy injections. To measure the effects of the treatment, researchers will monitor all the kids until they stop growing. Advocates of the drug’s wider use insist that while short stature is no disease, it can be a social handicap. They cite research showing that short people tend to lag in school, earn less money, and even lose elections. Twelve-year-old Marco Oriti has normal hormone levels but has always been small. After six years of treatment he’s still five inches behind some peers, but his mother credits the drug with narrowing the gap. Small risk: Someone else’s parents may find a smaller gap worrisome. Should any child with nervous parents receive years of costly medical treatment If the risks are minimal, and the public isn’t paying the bill, maybe there’s no harm (synthetic growth hormone isn’t known to cause serious side effects at standard doses.) But the implications are unsettling. If short stature is to be treated as a medical disorder, Rifkin asks, what other perceived handicap will follow Skin color Some researchers share those misgivings but defend the NIH study as an effort to identify the drug’s possibilities. At the moment, no one knows whether it will increase a normal child’s adult height or simply help him attain it faster. If synthetic growth hormone does not provide extra inches, says Dr Lynnette Nieman of NIH, the debate over treating healthy kids will be questionable. Maybe so. But if the drug works, science alone won’t tell us how to use it. Which of the following is NOT included in the disputed NIH trial
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