Human guinea pigs

SIR – James Le Fanu (Doctor’s Diary, November 20) raises the important matter of human medical experimentation. However, his example of a test from 1967 – in which participants’ hearts were catheterised as they exercised on a standing bicycle – is poorly chosen.

Research conducted 50 years ago clearly had none of the transparency that underpins more up-to-date ethical obligations to patients. However, modern techniques mean that procedures such as exercise catheterisation of the heart are now readily acceptable to patients as part of specialist clinical practice. These procedures continue to be carried out in large numbers.

The application of modern ethical standards to a bygone era inevitably leads to questions over the morality of the perpetrators. Quite correctly, this should be open to review. However, the evolution of what was then research into what is now clinically justifiable suggests that some good may have arisen from such experimentation.

Dr Colm Mccabe

London SW3