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From: sophie@mnetor.UUCP (Sophie Quigley)
Newsgroups: net.med,net.women
Subject: Re: Re: Breast Cancer Treatment.
Message-ID: <1400@mnetor.UUCP>
Date: Fri, 19-Jul-85 10:51:52 EDT
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Posted: Fri Jul 19 10:51:52 1985
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About assigning patients treatments for breast cancer randomly:
> 
> This is  standard  experimental  procedure.  Assuming  it  was  done  by  a
> reputable  institution,  the women involved would have known they were part
> of an experiment and probably signed a consent form stating they understood
> the nature of the situation.
> 
> Note that _all_ of the treatments involved have been used in  the  past  to
> treat breast cancer.  The purpose of the experiment was to determine if any
> one of them was more effective than the  others.  Without  the  results  of
> this  experiment  it's likely that total mastectomy would have continued as
> the treatment of choice for breast cancer.  Given the results, the women in
> the  total  mastectomy  group  of  the  experiment may be among the last to
> undergo such treatment.
> 
> I see nothing to worry Hippocrates here, or to justify a malpractice suit.
> -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_
> The Polymath (aka: Jerry Hollombe)

Well, maybe I should have made my point clearer.  It is my impression
that most people have opinions on things, so I would assume that most
doctors have an opinion on what they *think* is the best treatment for
a particular disease for a particular person.  Therefore if they are
not willing to provide what they think is the best treatment, then in
my opinion, they are not doing the best they can.  So, doctors who
encourage their patients to participate in such a study know that since
treatments are assigned randomly, there is a chance that their patients
will not be given as good a care as they might have given them had they
done what they thought was best.  This is what I objected to.  Of
course doctors who truly have no opinion on the matter are doing their
best by encouraging their patients to participate in such a study, but
how many doctors with any kind of experience truly have no opinion?

Maybe I should emphasise that I am talking about good intentions here
rather than success.  It is quite possible that doctors might prefer
a particular treatment which is not necessarily the best, so that
their patients would be better off being assigned treatments randomly,
but I think that in this case, those doctors still have failed their
patients by not insisting on giving them what they think is the best
treatment.

Before I get flamed into hell for this, let me add that I do not believe
that it is up to doctors to decide what their patients should do, but
it is their responsibility to inform their patients about all the
available treatments and their advantages and disadvantages, and then
let their patients decide for themselves.

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Sophie Quigley
{allegra|decvax|ihnp4|linus|watmath}!utzoo!mnetor!sophie