Ethical considerations in cancer chemotherapy.

Cancer treatment has improved dramatically in the recent past. As a consequence, the range of choices has been greatly broadened. With a much larger range of choices and a larger range of treatment disciplines available, decisions regarding treatment create major ethical burdens for the physician and for the patient. The participation of the patient in such choices improves the ethical posture of the therapist, whenever that is possible, and also improves the probability that the best treatment will be administered. Clinical research plays an important role in cancer treatment, not only in the the discovery of new treatment, but in the provision of the best possible care for patients participating in such research. At all levels of clinical research, such treatment has the potential for being the best available treatment when conducted in the most professional manner. While poor clinical research, like poor conventional treatment, certainly exists, it is nonetheless true that clinical research has a permanent place in cancer treatment and provides an important alternate to cancer quackery. Virtually every patient with a malignant disease has some effective treatment available to him, even in the most hopeless circumstance, where the Phase I type of clinical investigation still offers significant opportunity and hope.