Professor Duncan Vere lays before us the idealised guidelines used for recruiting volunteers on which to try and test new medicines. He points out that if these were followed rigidly, few, if any volunteers would be found for this vital work. Inducements are used, but the size of these determines whether society deems it right or wrong. However, the aim is to help and advise volunteers of the need for such tests and the risks involved and therefore the information leaflet (...) reprinted as part of the article indicates how the drug testers are attempting to encourage volunteers in as ethical a way as possible. To abandon human tests with new drugs may be unethical. A balance is sought. (shrink)

Physical pain has always been part of human experience, and throughout history it is recorded that doctors and wise men and women have sought to ease pain. The attitudes of those suffering pain, however, have varied from stoical acceptance to sullen endurance. Today, most people consciously seek to avoid pain or to have their pain eased, although they do not always expect what in fact appears to be possible. This study of 13 patients with protracted pain was carried out at (...) The London Hospital by a professional group to see how patients regarded their own pain and the efforts of doctors and nurses to relieve it. The attitudes of the doctors and nurses were also studied, and the results, despite the limitations of the survey, suggest that: [List: see text]. (shrink)

This paper was first presented at the London Medical Group's Annual Conference entitled Death: the last taboo held in February 1980. Dr Vere comments on the evidence of research done by him and his colleagues on the pain and discomfort suffered by patients who are dying and are in hospital. He contrasts this with the situation in hospices, analyses the differences, and attributes much of the unnecessary pain suffered in hospitals to attitudes of staff, as well as to a reluctance (...) by relatives to allow patients with terminal pain to die at home. He deprecates the tendency in hospitals to separate 'curing' and 'caring' and suggests that sometimes the best help involves 'doing' less, not more. (shrink)