DAVID SHANDER, M.D., F.A.C.P.
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To the editor: The article "Chronic Vasodilator Therapy in the Management of Cardiogenic Shock and Intractable Left Ventricular Failure" (Ann Intern Med 81:777-780, 1974) is an interesting, reasonably convincing demonstration of the effects of ventricular unloading on the management of left ventricular dysfunction.
I am concerned, however, about an aspect of the paper somewhat removed from the scientific content and which, I believe, is an example of "ethical unloading." Having found both subjective and objective benefits of the therapy in this severely ill patient, I find it difficult to understand why after 6 months of therapy they elected to discontinue
SHANDER D. Ethics in Vasodilator Therapy. Ann Intern Med. ;82:721. doi: 10.7326/0003-4819-82-5-721_1
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Published: Ann Intern Med. 1975;82(5):721.
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