O lord won’t you send me a Mercedes Benz…
In a recent letter to Cancer Investigation, David Steinberg, a hematologist at Lahey Clinic, Burlington, Mass, wrote:
“A $1,000 lottery ticket for a Porsche Boxster automobile was offered to the investigator who accrued the most patients to a Southwest Oncology Group prostate cancer protocol.”
“This was done” Dr. Steinberg says,” with the admirable intention of increasing patient accrual and improving the outlook for men with high risk prostate cancer.”
From the point of view of the patients pulled in as “bodies” for this trial, a skeptic might say, the intention was not necessarily admirable. How is a doctor going to give a patient a fair and unbiased evaluation of whether a trial is good for that indivual to enter when a Porsche beckons - And the patient doesn’t know about this? At the very least, the doctors should have been obliged to disclose their chance of winning the Porsche among other information required for the patient’s informed consent.
The Boxster is the fastest selling Porsche in history with a base price of $42,000, nicely loaded for $9,000 more.
Kudos to Dr. Steinberg for protesting this sleaze.
The offer of this prize, Dr. Steinberg writes, “makes the statement that it is permissible to reward a doctor with an expensive automobile for putting patients on an oncology research protocol. Awarding an expensive prize for patient accrual risks eroding public confidence by creating the perception that clinical investigators, swayed by the allure of an expensive automobile, were motivated by material self-interest rather than the welfare of their patients and the advancement of medical science.”
“I suspect that if the practice of expensive rewards for patient accrual became widespread,” Steinberg says, “the cumulative damage would ultimately outweigh the benefits.”
D. Steinberg,
Lahey Clinic Medical Center, Burlington, Massachusetts, USA.
Cancer Invest Volume 23, Number 8 / 2005
The Southwest Oncology Group (SWOG) and The Hope Foundation agree with the commentary that the perception of self-interest overshadowing the welfare of patients has no place in clinical trials. As the new Chair of SWOG, I reconfirm our commitment to making the wellbeing of patients and advancement of medical science paramount and as such, have reviewed and modified our policies. Although Dr. Steinberg accurately concludes that this situation is not an example of “scandalous unethical behavior,” nonetheless, steps have been taken to prevent actions that could lead to public misperceptions concerning the motivation of SWOG clinical researchers. Perceptions do matter and the potential damage to the patient /clinical investigator relationship is not worth a single additional accrual to this trial.
Laurence H. Baker, D.O.
Comment by meanna — January 5, 2006 @ 9:54 pmChairman, Southwest Oncology Group