Ethics of PCT decision making on funding cancer treatments

doi:10.1136/bmj.a1243

Published 11 August 2008, doi:10.1136/bmj.a1243
Cite this as: BMJ 2008;337:a1243

Letters

Funding cancer treatments

Ethics of PCT decision making on funding cancer treatments

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

We recently co-chaired the Cancer Agenda 2008 meeting with leadingcancer clinicians. One theme that emerged was the high levelof concern about the ethics of primary care trusts’ decisionmaking on funding cancer treatments.

Increasingly, clinicians feel tension between their obligationsto individual patients and society.¹ ² They are trained to providebest care for patients but recognise that this conflicts withthe NHS’s ability to provide optimal care to all patientswith all conditions in a just and equitable way in an economicallylimited system. Societal responsibility for these decisionsis expressed through the National Institute for Health and ClinicalExcellence (NICE), the Scottish Medicines Consortium, and similarbodies.

NICE’s judgments allow for non-approved treatments in"exceptional cases." The principle of natural justice supportsequity of treatment for all. This is being undermined by differentinterpretations of exceptionality; the decision to argue forexceptionality can put the responsibility—but neither. . . [Full text of this article]

Timothy S Maughan, professor of cancer studies¹, Joanne Rule, patient advocacy adviser¹

¹ Velindre Hospital, Cardiff CF14 2TL

Tim.Maughan@velindre-tr.wales.nhs.uk