Simon Wessely

A professor in the department of psychological medicine at the Institute of Psychiatry responds to our editorial criticising the clinical trials on babies in North Staffordshire
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The Independent Online

In all the talk of human guinea pigs, we have lost sight of why joining a clinical trial is often the best thing that a patient can do if he or she wants the best care. Research has consistently shown that patients in clinical trials often do better than those under normal care, even if they receive just a placebo.

Clinical trials usually deliver a standard of care that is far from routine in the rest of the NHS. Before joining a trial, patients usually have a complete health screening. Staffordshire notwithstanding, informed consent is obtained, which often means there is more explanation than can occur in busy out-patient clinics. Treatment will be closely monitored, with frequent, thorough assessments and checks.

Paradoxically, these strengths provide one frequent criticism of clinical trials. The clinical care that comes with a well-planned and well-monitored trial is, regrettably, not representative of real care in the NHS. It is there, outside the setting of a trial, that doctors may not properly explain what they are doing, routine checks may be overlooked and treatments may occasionally be given by overworked staff who lack enthusiasm for what they do.

Doctors who are sure that their treatment "works" and deliver it with charisma are rarely asked to account for what they do, even if the treatment lacks any scientific credibility. Yet, if the doctor expresses genuine uncertainty about whether a treatment really does work and embarks on the only honest course of action - a clinical trial to answer the question for the benefit of patients everywhere - then along comes the cry of "human guinea pigs".

As a researcher, I am proud that I am involved in clinical trials. I am moved by the willingness of patients to take part in these trials and to do something that may help not only themselves but others in the future. When I become ill, I want to take part in a clinical trial. Then I am likely to be under the care of doctors who are not afraid to admit when they don't know, and who are committed to finding out what really works for patients.

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