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One issue to consider is whether BMT really keeps patients alive longer than standard treatments. We don’t know, but the answer appears to be “probably not.’’ The patients naturally want to try anything that might keep them alive, and some doctors are willing to offer hope not backed by good evidence. One problem was that patients would not join controlled trials that might assign them to standard treatments rather than to BMT. Results from such trials were delayed for years by the difficulty in recruiting subjects. Of the first five trials reported, four found no significant difference between BMT and standard treatments. The fifth favored BMT—but the researcher soon admitted “a serious breach of scientific honesty and integrity.’’ The New York Times put it more bluntly: “he falsified data.’’

Another issue is “smart’’ compassion. Compassion seems to support making untested treatments available to dying patients. Reason responds that this opens the door to sellers of hope and delays development of treatments that really work. Compare children’s cancer, where doctors agree not to offer experimental treatments outside controlled trials. Result: 60% of all children with cancer are in clinical trials, and progress in saving lives has been much faster for children than for adults. BMT for a rare cancer in children was tested immediately and found to be effective. In contrast, one of the pioneers in using BMT for breast cancer, in the light of better evidence, now says, “We deceived ourselves and we deceived our patients.’’