Skip to main content

Clinical Trials, Industry and Doctors

Image
By
Despite general agreement on the pivotal role and necessity of “clinical trials” to usher in better treatments and to keep pushing the boundaries of what medical science can achieve, the term continues to evoke suspicion and cynicism in the minds of the public.
The history of clinical trials has been both epoch making as well as shameful.
During my recent discussions with an international pharmaceutical organization that has developed some promising new molecules for Hepatitis B and C and was trying to identify reliable hospitals and clinical investigators in India, I was told that clinical trials are banned in some states in the country.
Some investigator-doctors here had obviously flouted safety and research norms and jeopardised the lives of innocent patients.  But why did they do it? The possible reasons:there is often unusual eagerness to recruit patients in a trial as successes in the eyes of industry sponsors as well as financial remuneration are linked with the number of patients that a doctor recruits. Once recruited, many busy doctors often do not find time to closely monitor them for side effects. And if a patient does complain of unusual symptoms while on the trial therapy, the investigator-doctor is often reluctant to withdraw the patient from the drug as he fears his numbers might crumble.
All these failings of doctors are compounded in great measure by illiteracy and poverty of our patients. Speculations begin with how truly informed the ‘’informed consent” usually is for a patient who cannot read the 4 page document that he is expected to put his thumb impression on. Further, in a paternalistic medical climate ‘’where doctor always know best’’, does a poor patient who has surrendered himself completely and suffered a complication of a trial-treatment really has a voice to be heard?
Despite all these ugly tales, successful stories that have benefitted mankind can be found around each medicine that we prescribe or every procedure that we perform today. The discovery of the first antibiotic, penicillin, serves as a milestone. When two doctors, Chain and Florey embarked upon a clinical trial to test Dr Alexander Fleming’s new antimicrobial, patients and the public must have been just as sceptical. Severely infected patients were treated either with the potions of the day or with the experimental drug obtained from the penicilliummould. A few weeks later the researchers noted that while most who received the “standard of care treatment” of the day died, most receiving the ‘’experimental one” pulled through!
Perhaps the greatest challenge of our present times is to bask in the belief thatwe have reached the pinnacle and need not try out newer treatments any more. We should learn from the other systems of medicine that have all had their days in the sun but have stagnated due to lack of on-going researchand now live on as withered wisdom in moth-eaten books.

Medicine needs to move ahead to survive, but it surely needs to find a safer path.
As published in HT City ( Hindustan Times) dated 11 August, 2013.
Labels:

Comments

Post a Comment

Popular posts from this blog

How do you like your Tea?

By
The way we drink our tea may not only reflect our taste and style, but our health as well. Tea drinking is around 4700 years old and had its origin in China. Leaves of the shrub Camellia sinensis (tea plant) were in use at that time as a remedy for wounds and diseases. With the legendary emperor Shenong brewing and drinking its extracts, tea drinking became a popular habit in this part of the world. The British, impressed with the brew and the customs that go with drinking it in China and Japan, tried to emulate and evolve a tea-drinking custom of their own, and soon “tea-time”became a familiar term across the globe. Every home or cafe seems to have its own flavour. The north Indian variety of “chay” is a glass of hot creamy milk (more cream as it gets more “special”) with lots of sugar and a lacing of  “tea liquor” of strong tea that grows on lower heights (Assam, Nilgiri, Sri Lanka etc). In contrast, the Chinese and Japanese prefer light green or jasmine tea without a drop of mi...
Post a Comment
Read more

Food Fads in Liver Disorders

By
In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...
2 comments
Read more

Colas have No Class

By
Cola drinks, once a symbol of American upmarket style, is now to be found perched mainly on the shelves of road-side ‘paan walas’ and local grocers. True, there still are Americans who drink more colas than water, and consume an average of 2 bottles per day of the tangy fizzy dark drink, but it has clearly fallen in stature as offering it to visitors or serving it at parties is no longer elegant. Premiere schools in Lucknow such as La Martiniere College for girls have shunned colas from their canteen for the last 4 years. The story started with extensive campaigns by HOPE Initiative (Health Oriented Programs and Education) in 2005 creating awareness among the bright students about the long term harms of cola drinks. A heated debate followed in which the rights of an individual student  was pitched against the hazards of allowing gullible youngsters to be enticed by aggressive marketing to gulp colas and fall sick. The intelligent and alert La Marts students dcided on ...
Post a Comment
Read more