Henry S. Perkins, MD
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Perkins H.; Access to Experimental Drugs in Terminal Illness: Ethical Issues. Ann Intern Med. 1999;130:951. doi: 10.7326/0003-4819-130-11-199906010-00023
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Published: Ann Intern Med. 1999;130(11):951.
Schüklenk U. 228 pages. New York: Pharmaceutical Products Pr; 1998. $49.95. ISBN 0789005638. Order phone 800-429-6784.
Field of medicine: Palliative care and medical ethics.
Format: Hardcover book.
Audience: AIDS specialists, palliative care specialists, and medical ethicists.
Purpose: To advocate letting patients with terminal disease take experimental drugs outside of research trials.
Content: Using AIDS patients as a focus, the author draws on philosophy, science, and economics to support his position. He cites individual choice as a core western value and argues that society must permit people to make informed, logical choices, even though these choices may prove harmful to themselves. He decries medical science for limiting use of potentially beneficial experimental drugs to research trials and stresses that research helps only future patients, excludes the sickest current patients, uses substandard control treatments, measures clinical variables of little interest to patients, and is sometimes stopped before yielding definitive results. As an example, the author cites an early zidovudine trial in which prophylaxis against Pneumocystis carinii pneumonia was withheld, efficacy was determined only by CD4 counts, and therapy was stopped after 4 months. The author claims that past homophobia and current expectations for universal health care require society to ensure access to experimental drugs.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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