The road to hell is paved with good intentions and good intentions are surely what Dr. Suresh Katakkar had in his role with the BC Cancer Agency for the North.
By all accounts, Dr. Katakkar was an engaged oncologist, easily available to his patients and well-read and up-to-date on the latest drugs and treatments for cancer.
He was also a doctor who clearly put his patients before procedures.
This is where the road to hell comes in.
In the case of Holly Hill, Katakkar knowingly broke the rules laid out for him by the cancer agency.
"By definition I should have taken BCCA permission to do this," he wrote in his letter to patients published in full in Saturday's Citizen. "To get the permission to do something like this would have take a long long time."
What Katakkar was asking permission for was to try a treatment on Hill that he had tested 20 years ago, where a vaccine made up of fluids and cancer cells from the patient's body is injected back to them. According to his letter, he presented some encouraging findings at a New York Academy of Sciences-sponsored conference in 1992 but nothing came of it.
Despite what the conspiracy theorists may think, the medical community is working hard to find new and better treatments for cancer, hopefully leading to a cure. For both the doctors and the pharmaceutical company that comes up with those treatments, great wealth and immortality in medical history await.
That explains Katakkar's efforts but it still doesn't explain his willingness to forego the procedures in place and try the treatment on Holly Hill. With all due respect to his research, the results clearly didn't generate a buzz at the conference, encouraging researchers to explore a promising new avenue of cancer treatment. Furthermore, if Katakkar was so convinced he was onto something, he had 20 years to follow up with others in his field but it seems nothing came of it if he did.
Extensive medical research, including ethics review panels and anonymous peer reviews, are designed to make sure only the best and safest treatments are used on patients. While it may add a level of bureaucracy, this level of oversight protects both doctors and patients. It protects patients from doctors willing to go on personal hunches and educated guesses after exhausting established protocols. It also protects doctors from the emotional pressure of desperate patients willing to try anything, allowing the doctors to tell patients that just because there is information online about a treatment or a drug doesn't mean it's legitimate.
That points to the inequity in the doctor-patient relationship, but Katakkar brushed that aside in his letter.
"So what I did was with the full consent of the patient and the husband and the family and I felt as a physician I am morally obligated to do...," he wrote.
Full consent of the patient is critical but it's not enough. Doctor-assisted suicide does not happen in the jurisdictions where it's legal with just the consent of the patient. A review panel of doctors must also agree with the terminal illness diagnosis of the attending physician.
Just because Katakkar had the consent of his patients doesn't make his actions right. A patient in great pain and their suffering family are vulnerable, which is why more than just their consent is required to approve treatment. Left up to cancer patients, every new drug and treatment would be immediately approved for use, regardless of their effectiveness.
It appears the emotion of the moment and the temptation to do something caught Katakkar.
"I am a doctor first and giving hope to my patients in a dire situation is my moral obligation," he wrote.
Spiritual leaders and counsellors are in the hope business.
It is the moral obligation of doctors to treat patients as best they can, while also respecting the views of other doctors in the use and availability of those treatments.
-- Managing editor, Neil Godbout