The implications for Australia of the New Zealand report of the cervical cancer inquiry: no cause for complacency.
The New Zealand Cervical Cancer Inquiry established that patients with carcinoma-in-situ were left untreated in order to observe the natural history of their disease. Many patients developed invasive carcinoma unnecessarily and some died. The Inquiry found the research to have been unethical in that: the risk of progression to invasive carcinoma was known; the subjects had not consented to such study; and the study was designed and conducted poorly. The Inquiry was critical of the lack of proper review and the failure of responsible doctors and administrators to intervene in the interests of the patients. This article considers reasons for this failure and background issues of ethics and law. It is concluded that there is no cause for complacency in Australia in that provisions that are designed to protect patients may be ineffective. The NZ recommendations for changes in communication with patients, in the treatment of patients, in reviews of research, and in the training of doctors should be examined for their possible adoption in Australia.
McNeill
P M
PM
School of Community Medicine, University of New South Wales, High Street, Kensington.
D001291:Attitude of Health Personnel; D001315:Australia; D002278:Carcinoma in Situ / Q000473:pathology / Q000628:therapy*; D030881:Disclosure; D026724:Ethical Review; D028741:Ethics Committees, Clinical; D028744:Ethics Committees, Research; D004992:Ethics, Medical; D005260:Female; D033161:Government Regulation; D006801:Humans; D007258:Informed Consent; D009361:Neoplasm Invasiveness; D009520:New Zealand; D010344:Patient Advocacy; D028701:Patient Rights; D010380:Peer Review; D012107:Research Design / Q000592:standards*; D035842:Research Subjects; D018570:Risk Assessment; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*; D028761:Withholding Treatment