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: Anthony Axon
Format: Article
Language:English
Published: Wiley 2003-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2003/462148
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author Anthony Axon
author_facet Anthony Axon
author_sort Anthony Axon
collection DOAJ
description 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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spelling doaj-art-1f9f3977ddb8446f81d4674eef40c5bf2025-08-20T02:03:46ZengWileyCanadian Journal of Gastroenterology0835-79002003-01-0117Suppl B62B64B10.1155/2003/462148Ethical Issues in the Management of Helicobacter pylori InfectionAnthony Axon0Centre for Digestive Diseases, Department of Gastroenterology, The General Infirmary at Leeds, Leeds, UKMedical 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.http://dx.doi.org/10.1155/2003/462148
spellingShingle Anthony Axon
Ethical Issues in the Management of Helicobacter pylori Infection
Canadian Journal of Gastroenterology
title Ethical Issues in the Management of Helicobacter pylori Infection
title_full Ethical Issues in the Management of Helicobacter pylori Infection
title_fullStr Ethical Issues in the Management of Helicobacter pylori Infection
title_full_unstemmed Ethical Issues in the Management of Helicobacter pylori Infection
title_short Ethical Issues in the Management of Helicobacter pylori Infection
title_sort ethical issues in the management of helicobacter pylori infection
url http://dx.doi.org/10.1155/2003/462148
work_keys_str_mv AT anthonyaxon ethicalissuesinthemanagementofhelicobacterpyloriinfection