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I think Laurie hinted at some of the kinds of
distinctions we should make. I think -- and this, I think,
applies equally to this morning's session -- it might be
helpful if we had some paradogmatic cases to see if we
could agree on them and understand them. You know, are we
talking about sending someone into the PET scanner with an
A-Line is? Is that the kind of case that we are really
talking about as greater than minimal risk with no
potential benefit for them? Or is it something else? A
more invasive procedure than just an A-line but we are
talking about a -- you know, I do not know -- bronchial or,
you know, something else?
So I find this -- we are talking in the
abstract sometimes and I think having some cases might be
helpful.
The second thing I would like to raise is a
tension that I think I hear between research and clinical
care. A long standing relationship between the researcher
and the research population has certain advantages for the
prospective consent to get into a study. It also has the
problem, which I have confronted in oncology, of confusing
very easily in the mind of the patient whether this is
research or whether this is really clinical care.
No matter how many times you say it "no benefit