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Not Telling Patients About New Drugs is 'Unethical and Paternalistic'

Posted on: Friday, 4 November 2005, 06:00 CST

Withholding information from patients about new drugs that are not publicly funded is 'unethical and paternalistic', researchers said today.

Doctors in many countries face a difficult dilemma when they think a patient may benefit from a new and potentially expensive treatment, but it is not available through publicly funded health schemes. But researchers writing in the British Medical Journal said that if a patient would want the drug if it was free, doctors should tell them about this option even if they may not be able to afford to pay themselves.

In the UK some patients have resorted to lengths such as selling their homes, to pay for treatments denied to them on the NHS. There has been criticism about delays in guidance being issued by the National Institute for Health and Clinical Excellence (NICE), which leads to treatments being made widely available across the NHS in England and Wales.

The Government and NICE have now announced a new faster process to issue guidance on some important drugs quicker amid growing criticism from campaigners.

In the BMJ article, researchers from Oxford University and the Peter MacCallum Cancer Centre in Melbourne, Australia, surveyed 184 Australian cancer specialists about potentially useful but unsubsidised drugs.

They found that only a small proportion - between 28 per cent and 41 per cent - would discuss an expensive treatment with a patients if it were not subsidised because of the potential effect it might have.

Many said that the reason for not discussing the drug was that the knowledge that a patient could not obtain the drug would be too distressing for them or their family. Other doctors said they would feel bad mentioning a medication that the patient could probably not be able to afford.

'Our findings suggest that oncologists are concerned about the potential psychological and emotional effect that the discussions might have on patients and their families. The findings also indicate that these discussions are stressful for practitioners.

'Nevertheless, we query whether this practice is necessarily in the patient's best interests,' the researchers said.

They said that withholding information on the basis of what a patient would want is 'a dangerous medical path to unjustified paternalism'.

Source: Birmingham Post; Birmingham (UK)

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