John Lantos, MD weighs in on the SUPPORT study. He points out that the work of self-appointed “watch-dogs” such as Public Citizen and the Alliance for Human Research Protection are a danger to bioethics.

“Their criticism of this important trial also discredits bioethics. Bioethics, at its best, advocates for the most vulnerable patients and criticizes doctors and researchers who put those patients at risk. In this instance, OHRP and Public Citizen have, in the name of bioethics and advocacy, criticized clinical investigators who were trying to prevent the use of harmful and unvalidated treatments and, instead, endorsed an anti-intellectual, unscientific approach to medical innovation for the most vulnerable patients.”…

The New England Journal of Medicine ‘s web site has the early publication of an editorial about the controversy over the SUPPORT study of oxygen saturation levels in premature infants. This excellent editorial is accompanied by a letter to the editor by some of the investigators involved in the study and a Perspective article by Arthur Caplan and yours truly (David Magnus). The biased and misleading reporting by most of the media on this has been striking. Hopefully other journals and journal editors will join AJOB and NEJM and attempt to correct the misinformation campaign.…

When we go to the doctor and they recommend a treatment, we like to believe that there is good evidence that it is the best treatment available. The reality is that there are often several treatment options (different drugs, different dosing, different procedures) and which treatment you get may depend upon who your doctor is (Dr. A is sure drug X is better while Dr. B thinks drug Y is better—though neither view is well supported by the evidence).…

SICKLE CELL AND THE “DIFFICULT PATIENT” CONUNDRUM…

When does a doctor’s treatment of a patient become medical or surgical research? If what the doctor does is a standard and accepted method of therapy using proven medications or surgical techniques and represents nothing novel then at first glance what is occurring cannot be designated as research or can it? Ah! But here is where the issue of “innovative treatment” versus “medical/surgical research” become clouded. The United States government has set a standard regarding what activities by physicians could be called research and what could not based upon the April 19,1979 Belmont Report summarizing a governmental commissions conclusions and set the ethical standards for the ethics of research.…

This month’s issue features:

• On Moral Medical Repatriation
• Chimera Compulsion: Why Animals And Humans Deserve Better Arguments About Research
• Telecare for the Elderly: Concerns About Privacy, Autonomy, and Isolation

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