BMJ  2007;334:826 (21 April), doi:10.1136/bmj.39171.426690.AD

Feature

Head to head

Should you tell patients about beneficial treatments that they cannot have? Yes

Addenbrooke's Hospital, Cambridge CB2 2QQ

No healthcare system can afford to pay for all available treatments. Robert Marcus believes doctors have a duty to tell patients about unfunded drugs, but John Firth argues that it will cause them harm

The first 150 words of the full text of this article appear below.

A man who is losing vision in both eyes from macular degeneration seeks the opinion of an ophthalmologist. The doctor knows there is a new treatment that might save the sight of one or both eyes. It is available and doctors are able to prescribe it. But the treatment has not been approved by the National Institute for Health and Clinical Excellence and primary care trusts are refusing to pay for it. What should the ophthalmologist do?

We are not discussing a treatment that the patient wants but that the doctor considers is inappropriate. It is a treatment that is appropriate but cannot be offered purely for financial reasons.

The patient may or may not be willing to pay for it himself; may or may not have family willing to pay; and may or may not be able to sell his car, which he is unable to drive anyway, to . . . [Full text of this article]

Conflict of interest

Hypocrisy of deceit

Related Article

Should you tell patients about beneficial treatments that they cannot have? No

John Firth
BMJ 2007 334: 827. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Williams, M. V (2007). Ignorance is a public health issue. BMJ 334: 915-915 [Full text]  

Rapid Responses:

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Take the case of macular degeneration

Celine M Aranjo
bmj.com, 22 Apr 2007 [Full text]

Right of information : A patient’s perspective

Hemant Sharma, et al.
bmj.com, 25 Apr 2007 [Full text]

Ignorance is a public health issue

Michael V. Williams
bmj.com, 25 Apr 2007 [Full text]

Beneficial information?

Erik Buskens
bmj.com, 8 May 2007 [Full text]