PT - JOURNAL ARTICLE AU - Michael Baum TI - Clinical trials -- a brave new partnership: a response to Mrs. Thornton. AID - 10.1136/jme.20.1.23 DP - 1994 Mar 01 TA - Journal of Medical Ethics PG - 23--25 VI - 20 IP - 1 4099 - http://jme.bmj.com/content/20/1/23.short 4100 - http://jme.bmj.com/content/20/1/23.full SO - J Med Ethics1994 Mar 01; 20 AB - In this commentary on the previous paper it is explained that screen-detected Duct Carcinoma In Situ is effectively a new disease of unknown natural history. It is therefore impossible that 'the doctor knows best' and it is therefore both in the patient and the public's best interests that such cases are submitted to the rigours of the randomised controlled trial. Inevitably this brings the ethical dilemma of how to explain to patients the uncertainty and how to involve them in a rational decision to take part in the randomised controlled trial. It is argued that as well as there being a collective benefit for future generations of women, that we should resolve this problem now, the individual woman is likely to benefit from being treated according to a strict protocol. Nevertheless the time of diagnosis is paradoxically not the best time for a patient to become aware of these matters and it is about time that the lay public and the opinion formers recognized their responsibility to become acquainted with the benefits and the needs of the randomised controlled trial in anticipation of the day when they themselves will be patients.