.jpg)
It is with some consternation that I read reports about doctors who perform “treatments” that are not evidence based or generally accepted by the medical profession. More so when such practices are promoted by these doctors through articles in magazines for the public. I am concerned about the ethics of such doctors.
Yesterday, the news media had several reports on the Singapore Medical Council’s censure of a plastic surgeon after he pleaded guilty to unprofessional conduct by performing an unorthodox procedure on his patients. He had injected patients with sheep foetal cells as ‘anti-ageing’ treatment. The medical profession does not consider this as a responsible or acceptable practice.
At the Disciplinary inquiry the doctor had pleaded guilty, admitting that he had used unacceptable treatment for his patients. Yet the press reported him as having later stated that he had “always exercised my best professional judgment to provide the best treatments for my patients. I performed these treatments with my patients’ interest at heart”.
If the quote attributed to him is correct, I am saddened by this inconsistent response. As a doctor with many years of practice, he would be aware that the care that he provided had fallen short of the requirement of the SMC ethical code that “doctors are to treat patients according to generally accepted methods. A doctor shall not offer to patients management plans or remedies that are not generally accepted by the profession, except in the context of a formal and approved clinical trial”.
What sorts of treatments should be considered acceptable practices? Is performing the treatment on four people enough to be able to say that the treatment works, is safe and is the “best treatment”? How do we know that the effects are due to the product and not due to biased observation, a placebo effect or even chance? Would serious side effects have been discovered if it had been performed on more patients? Would the benefits of treatment outweigh the risk of the treatment?
These are questions that are best answered in a clinical trial that is scientifically designed and ethically sound. Those who participate in such trials should be made aware of the risks they face.
As highlighted in yesterday’s Straits Times article entitled ‘Most animal-cell therapies are of questionable value’, “A trawl through PubMed and other scientific databases turned up no clinical trials, while the websites advertising such treatments were long on testimonials but short on scientific evidence”. In fact there have been reports of cases of severe adverse effects such as a patient going into coma from similar therapy.
What are we to make of doctors who offer such unproven and potentially risky treatments to their patients? Is a doctor providing such treatment having the patients’ interest at heart?
Doctors must realise that they hold a privileged position: patients look to doctors expecting that they know more about medical science and rely on their advice to make treatment choices. Doctors must uphold this trust by acting ethically at all times.
Please visit our MOH Facebook page to leave a comment.
Posts
