Ch. 12 Case Study: A Patient Offered New Cancer Treatment Harriet Abeline had fa
ID: 90078 • Letter: C
Question
Ch. 12 Case Study: A Patient Offered New Cancer Treatment
Harriet Abeline had faced bad news before. She was diagnosed with breast cancer five years ago and underwent a lumpectomy and radiation treatment. Two years later, a routine mammogram revealed another lump. She used similar treatment for this tumor.
Harriet understood medicine. For years she had worked as a recruiter for a major drug company interviewing and hiring scientists and physicians. The company was a reputable and honest business and developed drugs that were used all over the world.
With each recurrence of cancer, she researched her situation and the available drugs being used for treatment. She also discovered that some cases of breast cancer are caused by a genetic predisposition. With each google search, she read about the experimental treatments that were available for end-stage breast cancer, keeping them in the back of her mind.
Her doctor told her that the cancer had spread to her bones. Harriet was frightened. Dr. Hill understood her fear. Harriet had been working with cancer patients for years and had recently been using some of the newer treatments available for late-stage cancers.
1. What should Harriet do? Should she be tested to see if she carries mutant alleles BRCA1 and BRCA2?
2. If Dr. Hill told Harriet that no other treatment could help her, might that make a difference in her decision to participate in the trial? Why or why not?
3. Many trials need end-stage patients to see how a drug might affect individuals who are very sick or dying. Can these patients really understand what the trials are about and give consent?
4. What should Dr. Hill tell Harriet about the proposed treatment before she agrees? List 5 items.
5. Is there anything that a researcher or physician shouldn’t tell a patient?
6. One serious problem in clinical trials is that researchers often cannot persuade patients to participate. Why do you think that is?
Explanation / Answer
1. Genetic testing for mutant alleles BRCA1 and BRCA2 is done to predict possible occurence of breast cancer in a woman whose family is prone to have breast cancer. Since it is only a screening test and does not offer any solution to a person who is suffering breast cancer in both breasts, the test may not be useful. Harriet should go for a treatment recommended by Doctor.
2. If she is told that her condition is terminal, she may lose interest to participate in any kind of trial as it is of no use. Her depression levels may also increase with no hope of recovery. But, it is ethical for Dr.Hill to inform her about the condition and encourage her to participate in the trial.
3. With proper counselling, these patients can be convinced that the data generated from trials on end stage patients is very important for the greater developments in medical science and for humanity and can get consent for trials.
4. Items Dr. Hill should tell Harriet before she agrees:
a) nature of the treatment
b) any discomfort or pain involved
c) duration
d) how is the treatment going to help harriet
e) impact of treatment - medical research, humanity
5. IT is the ethical and moral responsibility of a researcher or physician to tell the patient everything they are legally and ethically entitled to know
6. Lack of trust on the clinical trials and people cannot visualize themselves as guinea pigs by participating in clinical trials. People should be educated that clinical trials are for the greater good of humanity