General

Unapproved treatment

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19 Jul 2016 - General
 

The cited article mentions a case where a military hospital in China administered a form of immunotherapy to a patient of end-stage cancer. The fact of the matter was that this immunotherapy protocol was not an approved modality of treatment. The ethicality of treatment is being questioned.

The discussion on this topic can be endless. The point which I want to bring out is that should a patient who has no treatment options left, be allowed to take experimental therapy which has not yet passed through the guidelines of clinical research? Can some treatment which is in Phase I of clinical research be offered to a person if there are no options left?

Another angle of the question is that what if a patient and his/her relatives give an informed consent for undergoing a treatment which has not been standardised? This is a  question of medical ethics and guidelines versus the life of a person who has no treatment options available.

 

From what I remember if a drug is still in Phase III of clinical trial it can be given to those end of life patients who have exhausted every treatment option. If the drug can "promise life" it can be given to these patients. I do agree with palliative treatment as necessary if the drug has not been tested for efficacy and safety first. We definitely have our own opinions but we have different opinions with one ultimate goal which is to do what we think is best for our patient. For the...
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@Ziwei: I understand and respect your stand about this issue :) Not to convince you or anything, but I'd like to share a promising treatment thats currently on phase I trial. It's a newly developed vaccine using a genetically-engineered poliovirus as a treatment for recurrent glioblastoma. Glioblastoma is a devastating illness with a median survival length of 15 months despite maximal therapy. It is really a death sentence and ive seen numerous patient die from this. However, the Phase I...
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Marinelle I am strongly against your opinion in an amicable way. :) . I am a strong supporter of palliative medicine. The option of the novel treatment is not of cure but unknown end point, side effects and false promise. Everyone deserves to die in a painless way. I do not see going for a novel treatment with a terminal disease as a way of living to the fullest till the end. The point here is, the trial is still at phase 1. The correct dose, method of delivery, side effects are still not known....
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Hi Amit and Ziwei, I have a different take on this. The basis of my opinion will be ethical principles of autonomy and double-effect. A person who is dying with no options left has the right to try therapies which are still under investigation. Although patients and their relatives should be fully aware that there is no guarantee and these treatments may in fact bring about complications that may accelerate death. Not all dying patients are the same. Some patients would still struggle to live fo...
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I definitely agree that a treatment that has not even pass phase 1 of clinic research should not be promoted to the patient. There is always the option of palliative treatment which offer the patient a meaningful and painless way to accept and move forward to the end of life. Before the end of phase 1, the exact dose of the drug, side effect and effectiveness of a drug are not even known. Beside life expectancy, other determinant will be quality of life index. Dealing with a terminal illness, th...
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