When is it ethical to withold a drug from patients?
The New York Times had an interesting online viagra
th”>article on the ethical implications of clinical trials for medications. In the article, two cousins were diagnosed with melanoma; one received a new drug (PLX4032) that had slowed the spread of the disease in other patients, while the other was not eligible for this treatment because of the need for a control group to test the long term effectiveness of the drug.
“I think we have to prove it,” said Dr. Paul B. Chapman, a medical oncologist at Memorial Sloan-Kettering Cancer Center who is leading the trial. “I think we have to show that we’re actually helping people in the long run.”
But critics of the trials argue that the new science behind the drugs has eclipsed the old rules — and ethics — of testing them. They say that in some cases, drugs under development, PLX4032 among them, may be so much more effective than their predecessors that putting half the potential beneficiaries into a control group, and delaying access to the drug to thousands of other patients, causes needless suffering.
The topic raises a whole host of ethical issues, such as whether this treatment plan violates the Kantian formula that people should be treated as ends in and of themselves and not as means to some other end. One possible solution is to have a more flexible system of clinical trials where researchers can shorten the length of the trials if it seems medication is especially effective in treating the disease, or if there is a strong medical consensus that long term risks are unlikely.
Image by Flickr user dmason used under a Creative Commons Attribution License