A British stem cell scientist has called for mandatory participation in clinical trials because not enough people are wiling to participate. Professor Anthony Mathur, head of Advanced Cardiac Imaging at Barts and the London NHS Trust, complains on the BBC website that patients who have just had a heart attack are often eager to participate in his trials for curing heart disease with adult stem cells. But as soon as they feel better, they drop out of the program. Women and people from under-privileged areas are also less likely to participate.

Professor Mathur feels caught between a rock and a hard place. On the one hand, patients should have the right to choose whether or not to participate in medical research. On the other, the progress of medicine should not be held hostage to the availabilty of research subjects.

His solution seems radical, although some utilitarian bioethicists agree and contend that it is a matter of justice. “Maybe a new contract is needed between medicine and society that assumes a default position that says that everyone attending hospital should be involved in medical research, unless they specifically opt out of the process at the time of consent? This approach has already been used in some European countries for organ donation and has led to a quadrupling in consent rates,” he writes.

Writing on the Journal of Medical Ethics blog, David Hunter had little sympathy for Professor Mathur: “The issue presumably is that too many people exiting the trial threatens its viability - but surely the answer here is more resources, or a larger/longer study with more participants - rather than considering patients as obliged to participate in research.” ~ BBC, Dec 9