Thursday, August 6, 2009

Sham Surgery

Studies in which patients undergo phony surgeries are always interesting to me. The moral dilemma of asking a person to take part in a study in which they are taken to an operating room, perhaps put to sleep or at least drugged to some extent and then "invaded" by a knife, a needle, a scope or some other medical instrument is, in and of itself troubling and yet fascinating. At the same time it is impossible to deny the valuable facts that can be found with such studies. In this week's New England Journal of Medicine, two such studies are published involving a procedure called Vertebroplasty which is a treatment for spinal fractures caused by osteoporosis. The procedure was found to have absolutely no value to patients. It is scary to think about how many other surgeries and procedures are done every day that may have no value and yet puts people at risk. At the same time it is also scary to think about doing more sham studies, putting people at some risk of sedation, site infection, and other risks both major and minor to further this type of knowledge. I hope that we always consider the moral dimension for individuals as we preform these types of studies and also hope that we can eliminate surgeries and procedures that do not add value to a person's care.