The trick of hope — and the medical decision

Last night, during the intro show for the PBS documentary, Cancer: The Emperor of All Maladies, a Ken Burns film based on the book by Siddhartha Mukherjee, Katie Couric interviews both Ken Burns and Dr. Mukherjee. The moment occurred about 10 minutes into the video. There is a poignant scene in which two young parents struggle with the decision to enroll Olivia, their 17-month-old baby who has leukemia, into a randomized clinical trial to test one treatment over another. When the doctor tells the parents a computer randomization will determine Olivia’s treatment, you see anguish in their faces. They don’t want that. The parents want the treatment–the one that works. Presumably the active arm. Immediately after that scene the producers cut to the interview. Focus on Dr. Mukherjee’s answer. Katie Couric: We see Olivia’s parents agonizing over whether to participate in this clinic trial. It seems a sort of Russian Roulette with this person most precious to you. Siddhartha Mukherjee: Medicine is the most human of all the sciences that is stuck with the least human of all the experiments. And that is the randomized trial. Randomization doesn’t exist because doctors are maligned or because medicine is nasty. It exists for precisely the opposite reason. Because we hope too much. We are so hopeful, we want things to work so badly, that we will trick ourselves to believing that things are working. And there is nothing as toxic or lethal as that trick, the t...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs