Abstract
When a patient wants to enroll in a clinical trial to gain early access to an apparently promising but unproven intervention, her physician should clarify differences between participating in research and receiving treatment to help her avoid therapeutic misconception, make a thoughtful decision, and consider relevant clinical and ethical details. These include a patient's disease and treatment experiences, needs, interests, values, the design and phase of the trial, and the nature of the intervention being studied. When an unproven intervention is a nanodrug, a physician's role is especially difficult, because though nanomedicine might offer real benefits, it can also pose unexpected or even unprecedented harms. Thus, a physician should help a patient explore possible outcomes while promoting realism, countering hype, and preserving hope.