#1 By: Xeni Jardin, August 27th, 2013 13:04
#2 By: fuzzyfuzzyfungus, August 27th, 2013 13:16
I'm all for more aggressive risk taking (with the consent of) patients who are as thoroughly doomed as those ones; but a willingness to 'do first, oblige inconvenient oversight later or never' seems like a dangerously flexible sort of behavior for a doctor (especially if that doctor is also the primary source of the patients' information on which they are giving or withholding consent...)
I would want the IRB-or-equivalent to keep the situation in mind (no, it hasn't be tested on animals; but the patient will be dead before even a trivial animal trial could be conducted, so what're you going to do); but once people start doing experimental work off the books, it's basically luck whether you get a risky-but-good-faith attempt or whether you get somebody's pet quackery.
#3 By: Charlie, August 27th, 2013 13:19
I believe these treatments might have been legal in Germany, where patients have rights US patients simply don't.
And the physicians might have had a better chance of success if the medical-industrial complex hadn't denigrated and discarded Coley's work for a century in favor of radiation treatments. There are records of Coley curing fully metastasized cancers by infecting patients with dangerous bacteria (live bacteria at first, and later killed bacteria).
But medicine is not now a science, and was even less informed by the scientific method in the 19th century when Coley worked. We adjudge treatments as quackery or not based on false arguments from authority, for the most part.
#4 By: Shuck, August 27th, 2013 13:29
What strikes me as odd is that similar experiments have been done, inspired by the same idea, but not using live bacteria, so I'm unsure why they felt it necessary to use actual fecal bacteria, which is clearly quite dangerous.
The idea that infections help rid the body of cancer is an old one - when antibiotics were first introduced, the survival rate after surgery to remove tumors actually fell, as the cancer was more likely to return. I remember reading about this years ago. Some doctors were trying to make use of the dynamic by injecting proteins harvested from bacteria into surgery sites to provoke an immune response, in the hopes that it would have the same effect. Were these guys unaware of that work, or did they decide that the approach wasn't working?
#5 By: Marlborotestmonkey7, August 27th, 2013 13:56
#6 By: Preston, August 27th, 2013 14:01
#7 By: incarnedine_v, August 27th, 2013 14:04
#8 By: William_Holz, August 27th, 2013 14:22
Man, After reading the headline I was almost disappointed in the article!
(It was good, and thought provoking. . . it actually opened up some interesting rabbit holes in my brain and I'm trying to figure out if I'm letting emotion get in the way of reason on a subtle level)
But for now, I've still got this in the back of my head!
#9 By: He who must not be named, August 27th, 2013 14:55
If these doctors are any good they will get hired somewhere else. If the patients gave their consent and 'established' medical science knows no viable treatment, and the patients were on death's doorstep in any case, I can't see the harm -- although experimental treatments need to be analysed so that we can weed out the treatments that don't benefit the patient. The only crime would be if the doctors knew the treatment was useless, and carried it out anyway, or if they were not acting in the best interests of their patients.
#10 By: Boundegar, August 27th, 2013 17:05
Including the right to unsupervised human medical experimentation? Patients' rights don't excuse doctors who simply choose to throw their ethics out the window. And in this country, circumventing the FDA is utterly unethical - even if you are right.
I wonder if it would be possible to make this treatment available for self-administration? That would bypass a lot of ethical problems - maybe not all.
#11 By: Charlie, August 27th, 2013 17:23
The patients consented. If they weren't terminal, I might be concerned with how well informed their consent was.
Some people feel that it's perfectly OK to override the wishes of other people by force - that might makes right. That's pretty much the mainstream belief in the USA, in fact; you cannot have strong effective medicines here without either submitting yourself to a doctor and somehow obtaining his or her signature, or risking interaction with illegal marketplaces and corrupt law enforcement. Unauthorized healing has been criminalized; doctors alone decide who is qualified to receive specific treatments, and patients can just go hang if they don't like it. BTW "doctor" is a courtesy title, indicating that a physician is socially equivalent to a priest. PhDs are the "real" doctors historically, although most people don't realize this.
In other countries, patients are allowed to make decisions. I have heard Germany is one of those countries. Friends of mine spent a year in Germany and were confounded by the medical system, because the institutional arrogance of US physicians had trained them to obey mindlessly, and German doctors assumed the patient had a personal interest in their treatment and would want to discuss options.
#12 By: Mark K, August 27th, 2013 18:49
What a bunch of shitheads
#13 By: Mark K, August 27th, 2013 18:53
If your doctor is "forcing" you to accept a treatment then you need another doctor. Mine would never do that, nor have any doctors I've worked with.
PhDs may have been called doctors but time marches on and now it is accepted that medical doctors are the "real" doctors.
#14 By: GeekMan, August 27th, 2013 19:22
Sounds like a botched attempt at immunotherapy, which involves stimulating the immune system to destroy a tumour. My understanding is that, when it works, it works wonders. The problem is that medical science has no reliable methodology for infecting a patient who has a life-threatening illness with a life-threatening pathogen (go figure). Chemo and radiotherapy are brutal on the body, but they work much more reliably than immunotherapy.
#15 By: apoxia, August 28th, 2013 04:37
Funny that, the medical doctors I've spoken to (around 5) told me I was the "real" Dr with a PhD. One said they were the "real" Dr and I was the "true" D. One thing I know for sure, I know more about research than any of them and for that I am proud.
#16 By: Charlie, August 28th, 2013 12:06
Your doctor allows you to write your own prescriptions? That's pretty much illegal, I think. Most people in the USA get what the doctor decides they get - and the government violently enforces this monopoly.
Sure, in the exact same sense that it is accepted that dilution homeopathy works, you should worship an invisible sky man with an invisible penis, Arabs are not semitic, every man has a guardian angel, and a host of other "accepted" untruths.
#17 By: Charlie, August 28th, 2013 12:14
I think you're right. Lately people have been trying to revive Coley's work, that was dropped in favor of radiation treatments for mostly political reasons.
I lost a couple of relatives to early forms of chemo and radiation therapy. They boiled my grandfather like an egg - but it's OK; he consented, knowing the dangers, and he had terminal lung cancer already. The mistakes that were made on patients like him provided the data that makes radiation therapy as effective as it is today.
#18 By: fuzzyfuzzyfungus, August 28th, 2013 21:44
Is there anything suggesting that the treatments were illegal in the US? The facility the doctors were affiliated with appears to have freaked out about the issue, probably PR or liability; but no charges or lawsuits have been filed as yet, at any rate.
With the exception of the good narcotics(about which the DEA and friends are genuinely total assholes, I'm pretty sure people have even moralized about the addiction potential of painkillers for terminal patients, as though that's a major concern...) most of American medical conservatism is more about 'Will your insurer pay for that?' and 'Will you and/or your next of kin sue me for that?' rather than 'is that illegal?' Virtually anything that doesn't have enough documented deaths to get an underfunded section of the FDA into action can be sold as a 'food supplement' (so long as you nod/wink your medical claims) and more or less anything FDA approved for one purpose can be prescribed for any purpose, by any doctor, and then you have the procedures for experimental practices (and the numerous well-known schools of quackery that have operated more or less openly for years to decades without jackbooted Pharma Thugs knocking on the door).
#19 By: Charlie, August 29th, 2013 11:43
That's a good question and a good point. In the previous BB report on this case one of the links said charges were being considered and the doctors were going to have their licenses to practice revoked, but I haven't heard anything further about it since. Honestly I'm not tracking the case, I'm just annoyed by people who want to interpose bureaucracies between amateur researchers and terminal patients.
#20 By: Xeni Jardin, September 1st, 2013 13:04
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