Monday, March 06, 2006

I vant to drink your... fake blood?!? Bla?

Not long ago, I read a news report where trauma patients in Chicago and the surrounding areas were given fake blood. Well, not fake, really. Synthetic. A new form of synthetic blood, just approved by the FDA for testing in humans. Since trauma cases use lots of blood, it was decided to use this stuff, called Polyheme, as a stopgap in emergencies.

The ethics of this are shaky, to say the least.

There is the most obvious problem, of course. How can you use an experimental substance on someone without their consent?

Common ethical practice says no. People like to have their right to choose protected, and not giving an option takes away that right.

Of course, then it must be balanced against the potential good. Is it ethical to deny someone a right to assure them a chance of life? That's where it gets thorny.

Going further, we have the physician's duty to help. In effect, it states that when a patient is unable to decide for themselves, the physician can stand in as a surrogate decision maker, and act in what they consider the patient's best interest.

So what right to we deny? The patient's autonomy, or the physician's right and duty of care?

In this case, unfortunately, I have to break with my normal libertarian leanings, and side with the physician. Denying the patient's right to autonomy will also force the loss of their future rights by their death.

It's hard to decide. Polyheme is known to be quite safe, but where should the line be drawn? 10 heart attacks from Polyheme in heart patients, but how many is too many? I don't yet know.

4 Comments:

Blogger Bainwen Gilrana said...

It's a tricky thing. But if the patient is incapable of making the decision, and if it's a life-or-death situation meaning there's no time to track down the next-of-kin to obtain their consent, then someone has to make the decision.

I think the real ethical problem here lies in the question of why Polyheme is available to use yet. If it's an experimental substance, then how did it get out of the laboratory without having been fully tested for safety?

3/07/2006 9:43 AM  
Blogger Tirithien said...

Well... *dirty medical secret*

Aspirin has never actually been FDA approved. Neither have many drugs. It's not at all uncommon for real-world testing like this to occur.

3/07/2006 1:16 PM  
Blogger clew said...

Off topic, as promised I yelled "Squee!" at you Thursday. Once by the big gold mosque, once by he airport, and once in between. Didn't know which place was best so I did all three.

Hope it brought you luck!

3/08/2006 7:28 AM  
Blogger clew said...

(Bainwen, I would have squee'd you too but didn't go up Detroit way :D)

3/08/2006 7:29 AM  

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