2001

Introduction

Introduction

Virtually every significant health care decision has an ethical component. Partly in recognition of this, and partly because accreditation requires it, most health care institutions in BC have access to ethics resources. These can come in the form of a regional ethics committee, an ethics committee attached to the institution, or ethics consultants. All typically provide ethics education, write guidelines, and offer a consultation service.

Introduction

Autonomy is the right to choose, not an unfettered right to demand. However, where there is a duty to treat by the physician, there is a right by the patient to choose to be treated and an expectation in law and in ethics that it will be given. A terminal illness in itself does not affect autonomy or the right to choose. The patient at the end of life has no fewer rights than a healthy person.

I was recently asked by the Therapeutics Initiative to review the final draft of Therapeutics Letter number 39 (January/February, 2001) prior to publication.

I submitted several criticisms, particularly in reference to the authors’ decision to exclude placebo data from the major table comparing risks of various anti-inflammatory drugs. I am not surprised that my comments were not incorporated into the publication, or that I did not receive any explanation for this. My concern is whether they were considered in good faith by the authors.