They can, and of course many do. But many also tell us they fear it.
For cancers and other diseases with large patient groups trials exist.
But this isn’t the case for every disease.
Professor David Walker, Professor of Paediatric Oncology Faculty of Medicine Health Sciences, University of Nottingham explains:
“There will never be enough trials, they take time and money, there are rarely trials for the less common diseases.
“So when patients are in a situation with “nowhere else to go” and if there is no trial for which they are eligible, they need to be able to try treatments that might work, based upon the best judgment of their medical advisors.
“We need to allow them to try such new drugs that may be applicable and collect that experience to inform the next generation of trials.”
Innovating can be a high-risk enterprise, which many doctors seek to avoid.
There is a culture in the NHS that drives clinicians to stick to what are known as ‘standard procedures’. These are the prescribed norms of practice for any given illness.
Sticking to these gives the clinician protection in law in the event of a negligence claim – irrespective of whether the standard procedures are effective or not.
A doctor who, knowing his patient has little chance of survival, tries something new, even with the patient’s permission, may risk being taken to court or to a disciplinary tribunal, if the patient or their family later decides to sue or complain.
So, why try something new? Why innovate – when it is safer to stick to the well – worn path, even when that path leads to the death of the patient?
Professor Stephen Kennedy, clinical director of women’s services at Oxford University NHS Trust, told the Independent on 13th October 2013 he supports Lord Saatchi’s Bill because he said doctors are more risk averse in a more litigious culture, where they face being disciplined by the General Medical Council if they do not conform to standard practice.
“Doctors are afraid of being struck off for not following standard practice and they are afraid of how innovation is seen by the general public,
“The problem is particularly acute for rare cancers. What do you do when confronted with a patient with a rare cancer where the evidence base is not strong or when there is no evidence?”
Professor Andy Hall, Associate Dean of Translational Research at Newcastle University and an expert on bone cancer, said:
“There have been major advances in some areas, but in others it has been agonisingly slow, and we are still left with treatments that are extremely blunt instruments.
“Take, for example, bone cancer. Treatment frequently involves amputation and extremely toxic chemotherapy. Lord Saatchi’s Bill draws attention to the need to innovate when the prognosis of an individual patient is poor.”