Confidentiality
Hospital and Confidentiality
RCT: Dr. L's dilemma
In this particular ethical dilemma, patient Bruce W. is taking a placebo during a drug trial for a drug which is beginning to show promising results. Dr. L's dilemma is a common one for physicians involved in randomized clinical trials. Dr. L must weigh the value of the experimental method and his duty as a scientist with his duty as a physician. As a physician, Dr. L's ultimate responsibility is to his patient. He has an ethical obligation to keep the patient fully informed about treatment options and the risks and the benefits of the medications and treatments administered while the patient is under his care. But as a scientist participating in an experiment with a 'control' group, he has an ethical obligation to keep his patient in the dark about the patient's status as a control group participant. If the drug is promising -- as it seems to be --...
could have a longer lifespan if he takes the drug than if he remains 'as is,' but the better the research on the drug, the more apt it is to be approved the FDA for a large number of people.
Without a control group in a RCT, the improvement witnessed in the group under study could simply be due to reasons that correlated with the use of the drug, rather than were caused by it. Indeed, the fact that 24 of the 36 patients on placebos and only 15 of those receiving the new drug died seems to support use of the drug is based on the comparison between the placebo group and the experimental group. Still, there may need to reevaluate the existence of control groups in all forms of medical research. Perhaps in some instances they should not be used -- or should be discontinued mid-way through the study when illnesses are sufficiently life-threatening and the drugs are sufficiently promising. At present, the drug in question does…
