Attempting Miracle Cures with Unproven Treatments: Should Doctors Do It?
Let’s get down to brass tacks regarding miracles in medicine. We need to review the ethics of an issue physicians can face in their career. Patients and their families are looking for miracle cures when the illness has been treated, the treatment and additional treatment fails or as in the case of some diseases, such as symptomatic rabies, there is no treatment but only death. And the patient or their family will look at the physician and say “how about trying…?”, “I read about..”, “What else can you prescribe..?” How should the physician respond when the physician suspects the prognosis is nil. Should the physician respond frankly with “I have done all I can do.. there is nothing else to do for a cure.. but I can make you comfortable..”? Or should the physician under pressure from the patient and family not give up and perhaps concur with their requests or recommend a treatment that is unproven? After all, is there anything to lose? This action will demonstrate to the patient and family that the physician has their true interest at heart, he or she has listened to them and is willing to enter this adventure with them. Should this make the physician feel more comfortable and have no regrets regarding the outcome? Would the comfort also extend to the idea that there might be less chance for malpractice liability as initiated by the family?
But what is there to lose? What about providing an unproven therapy? Is there a scientific or an ethical rationale for experimenting a theory on a single patient? If the response is successful, what does this prove? And if not? Or does this not matter? What are the burdens to the use of unproven therapy in such cases as I have described? Would the toxicity kill the patient and not the underlying disease? Or should we look at the harms of treatment as irrelevant if the benefit is a miraculous recovery? What are other potential losses we can consider? How about an element of the profession of medicine that deals with society’s understanding that physicians practice under scientific principles and not as some irrational “witch doctor”? Would medicine lose society’s respect? And another question: who will pay for the unproven treatment? This deals also with justice and shepherding scarce resources such as providing that care and treatment is available to other patients? Would patients lose something they need by the act of utilizing unproven treatment on another patient?
Many questions but what are the answers? Miracles are miracles because they may be hoped for but realistically never expected to happen and if occurring are simply unexplainable. How far, if ever, should physicians go to reach for a miracle? ..Maurice.