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Access to Experimental Drugs in Terminal Illness. Ethical Issues
  1. Anthony Byrne
  1. Department of Palliative Medicine, University Hospital of Wales

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    Udo Schuklenk, New York, Pharmaceutical Products Press, 1998, 228 pages, US$60.

    Availability of, and equitable access to, therapeutic drugs have never been more topical or eagerly debated than at present. Public discontent, professional turmoil and political imperative have spawned exhaustive dicta on these issues, describing quasi-innovative frameworks for consensus such as evidence-based practice, clinical governance and integrated health care. However, controversies over autonomy, resource allocation and discrimination remain. In his book Udo Schuklenk proposes to highlight some of these issues, and more, in the context of those suffering from terminal illness, with particular emphasis on ethical issues arising from current health care practice.

    A thorough critique of such subject matter requires one to bridge the apparently inextricable but potentially disparate disciplines of ethics and clinical/pharmaceutical practice. That the author aims to achieve this so explicitly and precisely is both refreshing and reflective of his knowledge base. At the outset Dr Schuklenk explains his intent to explore the issues of the title using AIDS as the context of discussion and argument. He contends that observations made and conclusions drawn are applicable to the wider community with terminal illness, the choice of AIDS acting simply as a “real-world case study”. …

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