Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T04:57:20.301Z Has data issue: false hasContentIssue false

Assessment, Ethics, and the Randomized Controlled Trial

Published online by Cambridge University Press:  10 March 2009

Michael Baum
Affiliation:
King's College School of Medicine and Dentistry, Rayne Institute
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Decision-making in surgical practice is a highly complex interaction between the client (patient) and his or her professional advisor (surgeon). The client approaches the professional advisor full of expectations and fears. The expectations may be realistic or unrealistic, and, in the same way, the fears may be justified or unjustified. Furthermore, the client may have a variety of priorities not immediately apparent to the surgeon and may wish to express different degrees of autonomy. For example, some patients may demand the final say in determining the balance between length and quality of survival, whereas others would be happy to allow complete abrogation of their responsibilities to the surgeon, who is invited to make the difficult decisions concerning the patient's utilities. From the viewpoint of the surgeon, the transaction is equally complex, and his or her decisions may be constrained by resource allocation and time available. However, in the final analysis, assuming a beneficent doctor, the most appropriate decision will be determined by the weight of evidence that can be adduced in favor of any intervention.

Type
Editorial
Copyright
Copyright © Cambridge University Press 1989

References

REFERENCES

Angell, M.Ethics in international collaborative clinical research. New England Journal of Medicine 1988, 319, 1081–83.Google Scholar
Baum, M.Do we need informed consent? Lancet, 1986, 2, 911–12.CrossRefGoogle ScholarPubMed
Baum, M., & Houghton, J.Informed consent and controlled trials. Lancet, 1988, 2, 1194.Google Scholar
Faulder, C., Peckham, M. J., Baum, M., Bullimore, J. A., Cuzick, J., Durrant, K. R., Maguire, G. P., Sloane, J., Teasdale, C., Tobias, J. S., & White, H.Informed consent: Ethical, legal and medical implications for doctors and patients who participate in randomised clinical trials. British Medical Journal, 1983, 286, 1117–21.Google Scholar
McPeek, B., Mosteller, F., & McKneally, M.Randomized clinical trials in surgery. International Journal of Technology Assessment in Health Care, 1989, 5, 317332.Google Scholar
Marshall, T., & Moodie, P.Scrutinising research ethics committees. British Medical Journal, 1988, 297, 753.Google Scholar
Thomas, E.Informed consent. Lancet, 1986, 2, 1280.Google Scholar
Wittes, R. E., & Friedman, N. A.Accrual to clinical trials. Journal of the National Cancer Institute, 1988, 80, 884–85.Google Scholar