Controversy sparked in Switzerland after doctor who used unproved, unlicensed therapy is cleared of non-treatment conviction

BMJ 2009; 338 doi: (Published 06 January 2009) Cite this as: BMJ 2009;338:a3091
  1. Ned Stafford
  1. 1Hamburg

    A decision by Switzerland’s highest court to overturn a doctor’s conviction for failing to treat effectively “several patients” with cancer has been described as “a judicial scandal with disastrous ethical and medical implications” by a patients’ rights group.

    However, the Swiss Medical Association’s top lawyer disagrees, saying that strict new laws will prevent similar cases in the future.

    According to a judgment, issued 20 June 2008 by the Swiss Federal Court, an oncologist practising in Basel, referred to as X, treated at least 186 patients for breast or other cancers in 1998 and 1999 with lipoteichoic acid (LTA), which was manufactured by his company, although it was not licensed for such treatment. The standard treatment for some of the patients was tamoxifen, but in some cases this was stopped by Dr X in favour of lipoteichoic acid.

    One of the patients, known as Mrs Ad, was central to the case. According to the judgment she developed breast cancer in 1997, and after surgery on 14 August, was started on tamoxifen. Dr X started seeing her on 26 August that year and stopped tamoxifen in December 1997 even though evidence showed that treatment with the drug for five years substantially reduces the risk of recurrence.

    “Instead of using the standard treatment indicated, …

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