Physician as Researcher - Case H4Eric Overstreet is a fellow in neurology who has just joined a research team recruiting patients for a double-blinded clinical trial comparing two drugs in the treatment of multiple sclerosis, a severely debilitating disease. In anticipation of this project, Eric thoroughly reviewed previous studies of the properties of these drugs. His opinion is that drug A has been shown to be superior to drug B in relatively small trials. The trial now being undertaken should provide definitive results.
One day, Eric approached a patient to enter the trial. The patient asked, "Doctor, what do you think of these drugs? Should I enter this trial?" Eric feels conflicted. Until the trial is over, neither Eric nor the patient will know which drug he is receiving. As a physician, Eric believes it is his duty to provide the best therapeutic treatment possible for his patients, which under other circumstances would mean giving his patients drug A. As a scientist, however, Eric understands that his opinions concerning the respective benefits of these drugs require validation by this larger controlled study.
- Compare and contrast Eric's obligations as both physician and scientist in this case. Are they in conflict?
- How much credence should Eric give to his personal opinion of the relative efficacies of the agents?
- How should Eric solicit informed consent in this case? What information should he provide his patients to be certain that their consent will be informed?
- Does securing informed consent resolve any concerns you may have concerning Eric's obligations as a physician?
- What should Eric tell the patient about the drugs if both are available clinically? What should he tell the patient if only B is available clinically?
- Assume that this is a pharmaceutical company-sponsored study and both drugs are currently on the market. Does that situation raise any special questions?