Ethical Issues in the Management of Helicobacter pylori Infection
Medical ethics are not absolute; they change according to social attitudes, technological advances and alterations in the doctor/patient relationship. The discovery of Helicobacter pylori highlighted entrenched attitudes in academia and the pharmaceutical industry that were not always appropriate. T...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2003-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2003/462148 |
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| Summary: | Medical ethics are not absolute; they change according to social attitudes,
technological advances and alterations in the doctor/patient
relationship. The discovery of Helicobacter pylori highlighted
entrenched attitudes in academia and the pharmaceutical industry
that were not always appropriate. The explosion of research that followed
was ethically controlled by local research ethics committees
and the system of peer review and editorial responsibility. Now that
effective treatments are available, the control arm in trials of new
therapy should be either placebo (giving the option of effective treatment
later) or a first-line treatment; mono and dual therapy should
not be employed because of the risk of inducing bacterial resistance.
Ethical issues that still remain include whether always to test patients
for H pylori at endoscopy and what information should be given when
they test positive. The most important issue is the approach of the
medical profession to the high death rate carried by H pylori infection.
Peptic ulcer and gastric cancer together account for a large
number of deaths worldwide, and the medical profession and public
health services have not yet grappled with this problem, neither
advocating universal testing and treatment nor funding or research to
determine whether this approach would be effective. |
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| ISSN: | 0835-7900 |