CoChat
Sign Up
Cited by 74Ethics in Clinical ResearchEthics and bioethics in healthcarePatient-Provider Communication in Healthcare

The DOI matches its Crossref record; 20 of the 22 references it cites were found in a registry or an index.

Patient Expectations of Benefit from Phase I Clinical Trials: Linguistic Considerations in Diagnosing a Therapeutic Misconception

Weinfurt, K.P., Sulmasy, Daniel P., Schulman, Kevin A., Meropol, Neal J.·2003·Theoretical Medicine and Bioethics
DOI 10.1023/a:1026072409595
Open this paper in CoChat — free account

Abstract

The ethical treatment of cancer patients participating in clinical trials requires that patients are well-informed about the potential benefits and risks associated with participation. When patients enrolled in phase I clinical trials report that their chance of benefit is very high, this is often taken as evidence of a failure of the informed consent process. We argue, however, that some simple themes from the philosophy of language may make such a conclusion less certain. First, the patient may receive conflicting statements from multiple speakers about the expected outcome of the trial. Patients may be reporting the message they like best. Second, there is a potential problem of multivocality. Expressions of uncertainty of the frequency type (e.g., "On average, 5 out of every 100 patients will benefit") can be confused with expressions of uncertainty of the belief type (e.g., "The chance that I will benefit is about 80%"). Patients may be informed using frequency-type statements and respond using belief-type statements. Third, each speech episode involving the investigator and the patient regarding outcomes may subserve multiple speech acts, some of which may be indirect. For example, a patient reporting a high expected benefit may be reporting a belief about the future, reassuring family members, and/or attempting to improve his or her outcome by a public assertion of optimism. These sources of linguistic confusion should be considered in judging whether the patient's reported expectation is grounds for a bioethical concern that there has been a failure in the informed consent process.

Overview

Integrity signals

Registry

Crossref · 10.1023/a:1026072409595

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Surrogates' own prognostic estimates may have served as illocutionary acts-expressions intended to express positive attitude, optimism, or faith; highlight patients' unrecognized qualities of resilience; or counter clinicians' pessimism.

    “their own prognostic estimates may also have served as “illocutionary acts”—that is, expressions distinct from comprehension with which they intended to express positive attitude, optimism, or faith; to highlight patients’ unrecognized qualities of resilience; or to counter clinicians’ pessimism (15, 34–36).”

    From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [34]

Citations

Cites

Flagged first, then by citations

2 of the 22 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. Austin, J.L. “Performative Utterances.” In Philosophical Papers. 2nd ed. Edited by J.O. Urrnson and G.J. Warnock, 233–252. Oxford: Oxford University Press, 1970.
  2. DiMascio, Jeffrey, J. Babb, S.L. Corbett, E. Slater, A.B. Benson, A. Balshem, K.A. Schulman, H. Wang, and N.J. Meropol. “Discordant Perceptions of Fellows and Attending Physicians Regarding Phase I Trials. Proceedings of the American Society of Clinical Oncology 21 (2002): 259a.
  3. Meropol, Neal J., K.A. Schulman, K. Weinfurt, C.B. Burnett, A. Balshem, A.B. Benson, L.D. Castel, S.L. Corbett, J. Marshall, J. Rowland, E. Slater, D.P. Sulmasy, and D.A. VanEcho. “Discordant Perceptions of Patients and Their Physicians Regarding Phase I Trials.” Proceedings of the American Society of Clinical Oncology 21 (2002): 245a.
  4. Searle, John. “What is a Speech Act?” In The Philosophy of Language, 2nd ed. Edited by A.P. Martinich, 115–135. New York: Oxford University Press, 1990.
  5. Teigen, Karl H. “Variants of Subjective Probabilities: Concepts, Norms, and Biases.” In Subjective Probability. Edited by G. Wright and P. Ayton, 211–238. London: Wiley and Sons, 1994.

Cited by

Sorted by citations

Related

Metadata

Authors
Weinfurt, K. P., Sulmasy, D. P., Schulman, K. A., & Meropol, N. J.
Affiliations
  • Duke University (US)
  • New York Medical College (US)
  • Duke Medical Center (US)
  • Fox Chase Cancer Center (US)
Corresponding author
Weinfurt, K.P.
ORCID
Venue
Theoretical Medicine and Bioethics
Publisher
Springer Science and Business Media LLC
Published
2003-07
Volume
24
Issue
4
Pages
329-344
ISSN
  • 0166-2031 (ISSN-L)
  • 1386-7415
  • 1573-1200
DOI
10.1023/a:1026072409595
OpenAlex
W1516915792
Cited by
74
References
22
Citations by year
2026: 1 · 2024: 1 · 2023: 2 · 2021: 4 · 2020: 2 · 2019: 5 · 2018: 2 · 2016: 7 · 2015: 5 · 2014: 1 · 2013: 4 · 2012: 5
FWCI
4.70
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Metamedicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
National Cancer Institute (R01CA082085)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
therapeutic misconception, informed consent, cancer patients, philosophy of language, multivocality, speech acts, clinical trial ethics
MeSH terms
Colonic Neoplasms, Female, Humans, Informed Consent, Linguistics, Liver Neoplasms, Lung Neoplasms, Middle Aged, Patients, Physician-Patient Relations, Treatment Outcome, Clinical Trials, Phase I as Topic, Risk Assessment, Comprehension, Uncertainty

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review