Genentech, Inc., manufactured Protropin, a genetically engineered version of the human growth hormone. This drug’s purpose was to enhance the growth of short children.

Protropin was an important product for Genentech, accounting for more than one third of the company’s total revenue of $217 million.

Although the drug was approved for the treatment of children whose bodies made inadequate quantities of growth hormone, many doctors prescribed it for children with normal amounts of growth hormone who simply happened to be short. There was no firm evidence that the drug actually increased growth for short children with normal growth hormone.

Moreover, many people questioned whether it is appropriate to prescribe such a powerful drug for cosmetic reasons, especially when the drug might not work. Nor was there proof that it was safe over the long term. Was Genentech behaving ethically? Should it have discouraged doctors from prescribing the drug to normal, short children?