Phase I oncology trials: why the therapeutic misconception will not go away

In many cases, the “therapeutic misconception” may be an unavoidable part of the imperfect process of recruitment and consent in medical research Paul Appelbaum, Loren Roth, and Charles Lidz coined the term “therapeutic misconception” in 1982.1 They described it as the misconception that participati...

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Bibliographic Details
Main Author: Glannon, W. (Author)
Format: Electronic Article
Language:English
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Published: BMJ Publ. 2006
In: Journal of medical ethics
Year: 2006, Volume: 32, Issue: 5, Pages: 252-255
Online Access: Presumably Free Access
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Summary:In many cases, the “therapeutic misconception” may be an unavoidable part of the imperfect process of recruitment and consent in medical research Paul Appelbaum, Loren Roth, and Charles Lidz coined the term “therapeutic misconception” in 1982.1 They described it as the misconception that participating in research is the same as receiving individualised treatment from a physician. It referred to the research subject’s failure to appreciate that the aim of research is to obtain scientific knowledge, and that any benefit to the subject is a by-product of that knowledge. More recent studies by Appelbaum and Lidz have shown that this phenomenon is just as pervasive now as it was twenty four years ago.2 The problem pertains not to any duty of care for researchers but to participants’ unfounded belief in the therapeutic potential of research.3 It is especially acute in phase I oncology trials, which aim to test the toxicity and highest tolerable dose of anticancer drugs. To remedy this situation, many have argued that both clinicians and researchers need to do more in explaining to subjects the differences between experimental research and standard care. Clinicians and researchers recruiting potential subjects for research must present information about the expected risks and benefits of participation in research in a more realistic and straightforward way.4 In one recent examination of consent forms for phase I oncology trials, Sam Horng et al found that, in the section on “benefit”, only one of 272 forms stated that the subjects were expected to benefit. They also found that 11 consent forms (four per cent) stated clearly that subjects would not benefit, 25 forms (nine per cent) communicated uncertainty about benefit, and 5 forms (two per cent) said nothing about the chance of benefit. Interestingly, 139 forms (51 per cent) alluded to the …
ISSN:1473-4257
Contains:Enthalten in: Journal of medical ethics
Persistent identifiers:DOI: 10.1136/jme.2005.015685