How participants in cancer trials are chosen: ethics and conflicting interests.

Abstract

The development of new drugs for cancer is extremely complex and expensive, and poses ethical problems. In this article we will review issues in clinical trials for cancer drugs that will cast new light on the doctor-patient relationship and their interaction with industry, the health service, academic and administrative organizations. We show that the Declaration of Helsinki cannot be applied to cancer trials as it is currently written, that patients do not and perhaps cannot give fully informed consent to participate, and that the results of clinical trials do not translate into daily practice in a way that patients might expect.