University of Portsmouth ethics expert warns over dummy drug

Lecturer David Carpenter has voiced concerns over some heart patients being given a placebo
Lecturer David Carpenter has voiced concerns over some heart patients being given a placebo

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A LECTURER has questioned how ethically moral it is to inject heart patients with a dummy drug without getting consent.

David Carpenter is the principal lecturer in social and political philosophy at the University of Portsmouth.

He used to teach medical ethics and medical law within the NHS and said a new trial looking at how effective adrenaline is on cardiac arrest patients needs to be changed.

Under the trial neither the patient nor the paramedic would know if adrenaline or a saline solution was being injected.

Mr Carpenter said: ‘The trial is a standard design but I still think that it’s unethical to give a person, unable to consent, a placebo – because it can never be in their interests to do so.

‘It would, however, be defensible to give nothing in circumstances where the value of giving adrenaline is questionable – the adrenaline might be of no benefit or, indeed, it might be harmful.’

As reported, South Central Ambulance Service (Scas), which serves this area, is one of five health trusts to take part in the double-blind trial.

Dr Martin Underwood, from the University of Warwick is leading the trial, and said the aim is to determine whether adrenaline improves survival.

Mr Carpenter said that the principle of the trial was sound, but that ethically and legally it opened a lot of questions.

He said: ‘There is a genuine belief that in these cases adrenaline may not be helping.

‘A randomised test is good because then the paramedic will carry on treating a patient as they usually would.

‘However there is a big but to this – where I find the problem is giving a placebo.

‘Giving someone an inactive substance seems indefensible.

‘Ethically and legally this is problematic.

‘You can use your best judgement to withhold medication if you do not think it’s in the patient’s interest, but injecting something inactive isn’t defensible.

‘Also if someone is having a cardiac arrest, they can’t consent or refuse the trial – the model needs to be looked at.’

Warwick university said advertising campaigns telling patients how to opt out if they want will run.

Scas said it will carry out a small pilot at the end of this year, before rolling it out across the entire trust patch by Easter next year.