Open AccessReferral of patients with cancer for participation in randomized clinical trials: Ethical considerations
Author(s) -
Levine Robert J.
Publication year - 1986
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/canjclin.36.2.95
Subject(s) - haven , citation , referral , alternative medicine , medicine , randomized controlled trial , clinical trial , cancer medicine , psychology , cancer , family medicine , library science , pathology , computer science , mathematics , combinatorics
Physicians with patients with cancer may be faced with two conflicting ethical obligations. One is to contribute to the advancement of scientific knowledge. Among the ways available to respond to this duty is to refer patients for participation in RCTs. The second obligation is to serve the health interests of the individual patient. When these two duties conflict, the latter obligation to the individual takes priority. In the words of the Declaration of Helsinki, "Concern for the interests of the subject (patient) must always prevail over the interests of science and society." Quite often there is no conflict. The patient can pursue his or her health interests most effectively by enrollment in an RCT. In such cases, the referring physician can contribute to the success of the patient's participation in the RCT by explaining what the patient can expect to experience as a patient-subject. It is usually important to explain that referral does not necessarily entail severing the original doctor-patient relationship.