The ‘false hope’ argument in discussions on expanded access to investigational drugs

A critical assessment

Bibliographic Data

ID21702646
AuthorsMarjolijn Hordijk (0009-0005-5721-344X, Erasmus MC), Stefan F Vermeulen (0000-0002-8797-9172, Erasmus MC), Eline M Bunnik (0000-0003-1481-6222, Erasmus MC, corresponding author)
Year2022
Volume25
Issue4
Pages693-701
Publication date2022-12-01
Open AccessYes
TypeARTICLE
VenueMedicine Health Care and Philosophy (JOURNAL)
Journal identifiersISSN: 1386-7423 • E-ISSN: 1572-8633
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s11019-022-10106-y
PMID35951276
OpenAlexW4291016006
LanguageEN
Citations received3
References cited45

When seriously ill patients reach the end of the standard treatment trajectory for their condition, they may qualify for the use of unapproved, investigational drugs regulated via expanded access programs. In medical-ethical discourse, it is often argued that expanded access to investigational drugs raises ‘false hope’ among patients and is therefore undesirable. We set out to investigate what is meant by the false hope argument in this discourse. In this paper, we identify and analyze five versions of the false hope argument which we call: (1) the limited chance at benefit argument, (2) the side effects outweighing benefits argument, (3) the opportunity costs argument, (4) the impossibility of making informed decisions argument, and (5) the difficulty of gaining access argument. We argue that the majority of these five versions do not provide normative ground for disqualifying patients’ hopes as false. Only when hope is rooted in a mistaken belief, for example, about the likelihood of benefits or chances on medical risks, or when hope is directed at something that cannot possibly be obtained, should it be considered false. If patients are adequately informed about their odds of obtaining medical benefit, however small, and about the risks associated with an investigational treatment, it is unjustified to consider patients’ hopes to be false, and hence, to deny them access to investigational drug based on that argument

Alternative medicine · Epistemology · Impossibility · Law and economics · Medical law · Normative · Odds · Philosophy of medicine · Political science · Sociology · Biomedical Ethics and Regulation · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Law · Medicine · Philosophy · Psychology

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