"Rescue" technologies following high-dose chemotherapy for breast cancer: how social context shapes the assessment of innovative, aggressive, and lifesaving medical technologies

Kelly, Susan E. and Koenig, Barbara A. (1998) "Rescue" technologies following high-dose chemotherapy for breast cancer: how social context shapes the assessment of innovative, aggressive, and lifesaving medical technologies. In, Boyle, Philip J. (ed.) Getting Doctors to Listen: Ethics and Outcomes Data in Context. (Hastings Center Studies in Ethics) Washington DC. Georgetown University Press, pp. 126-152.

Abstract

In 1995, two women at Dana-Farber Cancer Institute were given accidental overdoses of chemotherapy as they underwent experimental high-dose treat­ment for metastatic breast cancer. One woman died, the other was seriously injured. The goal of high-dose chemotherapy is to kill the maximum numberof cancer cells; the drugs used are so potent they destroy not only the malignant cells but the patient's own blood-producing system as well. Even at conventional levels, the drugs given are highly toxic. Experimental high-dose chemotherapy requires doses so large the patient must subsequently be "rescued" by infusion of new bone marrow or blood-producing stem cells. Breast cancer patients risk death in order to buy a chance at cure. The mistaken doses of chemotherapy at Dana-Farber tragically highlight the tension between hope for cure and the destructive potential of aggressive, potentially life-saving therapies. If desperate women—and their physicians—are willing to take such risks, how can new therapies such as bone marrow transplant for breast cancer be evaluated? Innovative, dramatic, and lifesaving technologies hold special cultural appeal in the United States. What features of this unique social context shape the technology assessment process?

This record has no associated files available for download.

Contributors

Download statistics