A 34-year-old woman with major depressive disorder comes
to the physician for a follow-up examination. She says that
her depressive symptoms are worsening. Multiple medication
regimens have been ineffective. The patient says that she
spoke recently with a former college roommate who also has
depression. Her friend is currently enrolled in a clinical trial
for a new antidepressant at a local center. The patient says,
"My friend seems to be doing really well with this new
medication, and I think I'd like to try it out to see if it would
work for me, too. Can you write me a referral to the center
where my friend is enrolled?" Which of the following is the
most appropriate initial response by the physician to this
patient's request?
(A) Decline to refer the patient because she has
treatment-refractory depression that
typically is not accepted into clinical trials
(B) Discuss the conduct of clinical trials so that the
patient has a clear understanding of how
they operate
(C) Inform the patient that she cannot receive future
care from the physician if she enrolls in the
clinical trial
(D) Inform the patient that she will not get the best
care possible if she enrolls in an
experimental trial
(E) Refer the patient to the center because so many
other treatment options have failed