Therapeutic misunderstandings in modern research
Details
Publication Year 2024-02,Volume 38,Issue #2,Page 138-152
Journal Title
Bioethics
Publication Type
Research article
Abstract
Clinical trials play a crucial role in generating evidence about healthcare interventions and improving outcomes for current and future patients. For individual trial participants, however, there are inevitably trade-offs involved in clinical trial participation, given that trials have traditionally been designed to benefit future patient populations rather than to offer personalised care. Failure to understand the distinction between research and clinical care and the likelihood of benefit from participation in clinical trials has been termed the 'therapeutic misconception'. The evolution of the clinical trials landscape, including greater integration of clinical trials into healthcare and development of novel trial methodologies, may reinforce the significance of the therapeutic misconception and other forms of misunderstanding while at the same time (paradoxically) challenging its salience. Using cancer clinical trials as an exemplar, we describe how methodological changes in early- and late-phase clinical trial designs, as well as changes in the design and delivery of healthcare, impact upon the therapeutic misconception. We suggest that this provides an impetus to re-examine the ethics of clinical research, particularly in relation to trial access, participant selection, communication and consent, and role delineation.
Publisher
Wiley
Keywords
Humans; Informed Consent; *Therapeutic Misconception; *Neoplasms/therapy; Communication; Forecasting; Bayes theorem; adaptive clinical trial; clinical trials; research ethics; therapeutic misconception
Department(s)
Palliative Care; Medical Oncology
Open Access at Publisher's Site
https://doi.org/10.1111/bioe.13241
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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