Argument: This policy enhances the role of drug reps and advertising, at the cost of evidence-based medicine

By allowing anyone who is critically ill to use experimental drugs you enhance the already dubious role of drug company reps: especially in the USA, (where doctors do not operate under the NHS guidance found in the UK), there is already a problem of patterns of prescription being altered by the techniques of drug reps, rather than by evidence1. Where drugs are for sale before they have completed testing, there is even less evidence available, and therefore less ability for physicians to contest the claims of either reps or their own patients (who may have heard of the drug during their own research). Hence you magnify the problem of potentially ineffective of even harmful prescription.

1 Harris, Gwyn, ‘Pharmaceutical representatives do influence physician behaviour’, Family Practice, Vol.26 2009, pp.169-70, http://fampra.oxfordjournals.org/content/26/3/169.full

Candidate 1: "First, this may well be overridden by the individual rights of present patients (see proposition arguments).

Second, the greater time taken to recruit is one that may be offset by greater numbers: whilst the trial will be of a lower quality (no control group, etc.) there will nevertheless be a greater number of people willing to take the drug (people who wouldn’t have wanted to be part of a trial, but are willing to try the new treatment). Consequently, it may well be possible to compensate for the other problems with the trial. Further, alternative trialling models can be employed, for example using patients who choose not to take the drug as the control group. Whilst you lose the benefit here of having a double-blind trial (as under the status quo), you gain in terms of the benefits to current patients."
Candidate 2: "Doctors are trained in the presentation of news to their patients. This includes the delivery of bad news, and the dispelling of media-myths. Patients with terminal illnesses are often well-informed about their disease, and (in particular those with chronic conditions) often gain a good understanding of the possibilities of future treatments.

The risk that they may all get carried away on a wave of false hope is, consequently, minimal. Patients in this circumstance are more than capable of reaching, in conjunction with their physician, an informed decision regarding experimental drugs, and make a choice accordingly. The moderate risk of someone making an error in no way outweighs the chance of giving someone some more time with their family.

Countries that already allow access to treatments that have not completed trials do not just allow the doctor to simply proscribe the drug as with any other. Rather the doctor will need to apply for access to the drug.1 In addition the drugs company will also have to give its approval.2 As a result it is unlikely that the patient will consider this the same way as they do normal drugs.

1 ‘Special Access Programme – Drugs’, Health Canada, 15 August 2005, http://www.hc-sc.gc.ca/dhp-mps/acces/drugs-drogues/sapfs_pasfd_2002-eng.php

2 ‘Compassionate Use of Unapproved Investigational Product’, Pfizer, http://www.pfizer.com/research/research_clinical_trials/compassionate_use_policy.jsp"
Candidate 3: "There is no reason why, under this model, you could not retain suitable precautions to ensure that this doesn’t happen.

For example, you could continue the obligation for companies to sell the drug at cost (they would, naturally, continue to be incentivised by the huge profits they expect to make when the drug is licensed). Further, you could impose financial sanctions on companies that refused to take appropriate action towards completing testing."
Candidate 4: "Drugs that are still undergoing clinical trials do not have a complete void of information about them. Presumably this policy covers drugs that have completed at least some testing in humans (say, phase one of the trials), and therefore at least some information would be available on which doctors and patients could base their decisions.

Further, it is implausible to suggest that doctors are entirely under the sway of advertisers: whilst drug reps under the status quo have some influence in getting a doctor to use one drug rather than another, this is in instances where there is little to choose between those products, and (importantly!) both are licensed, safe and effective. They would clearly not be so reckless as to blindly follow a drugs rep and prescribe an untested product to their patient."

Drugs that are still undergoing clinical trials do not have a complete void of information about them. Presumably this policy covers drugs that have completed at least some testing in humans (say, phase one of the trials), and therefore at least some information would be available on which doctors and patients could base their decisions.

Further, it is implausible to suggest that doctors are entirely under the sway of advertisers: whilst drug reps under the status quo have some influence in getting a doctor to use one drug rather than another, this is in instances where there is little to choose between those products, and (importantly!) both are licensed, safe and effective. They would clearly not be so reckless as to blindly follow a drugs rep and prescribe an untested product to their patient.
