SOME years ago emphasis on informed consent made me realize that I could get most of my patients to participate in almost any kind of clinical study. They would swallow new drugs, receive infusions of calcium or glucagon, or even embrace esophageal or rectal catheters because they had faith in my goodwill or, I now fear, because they wanted to please me. Differences between patients and subjects were not always explicit in earlier times, and I am sure that other academic physicians also had the idea that we had the implicit right to carry out experimental observations on patients without telling them what we were doing. Certainly there was an unexpressed agreement that charity patients, beneficiaries of endowed "free" beds, were under some obligation to repay the beneficences bestowed on them by participating in our experiments. We gave them our minds and they gave us their bodies in a "civic
Spiro HM. Mammon and MedicineThe Rewards of Clinical Trials. JAMA. 1986;255(9):1174–1175. doi:10.1001/jama.1986.03370090096030
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