2. 外语
  3. Under existing law, a new drug may be labeled, promoted, and advertised only for those conditions in which safety and effectiven

Under existing law, a new drug may be labeled, promoted, and advertised only for those conditions in which safety and effectiven

admin2012-05-18  33
问题     Under existing law, a new drug may be labeled, promoted, and advertised only for those conditions in which safety and effectiveness have been demonstrated and of which the Food and Drug Administration (FDA) has approved, or so-called "approved uses". Other uses have come to be called "unapproved uses" and cannot be legally promoted. In a real sense, the term "unapproved" is a misnomer because it includes in one phrase two categories of marketed drugs that are very different; drugs which are potentially harmful and will never be approved, and already approved drugs that have "unapproved" uses. It is common for new research and new insights to demonstrate valid new uses for drugs already on the market. Also, there are numerous examples of medical progress resulting from the serendipitous observations and therapeutic innovations of physicians, both important methods of discovery in the field of therapeutics. Before such advances can result in new indications for inclusion in drug labeling, however, the available data must meet the legal standard of substantial evidence derived from adequate and well-controlled clinical trials. Such evidence may require time to develop, and, without initiative on the part of the drug firm, it may not occur at all for certain uses. However, because medical literature on new uses exists and these uses are medically beneficial, physicians often use these drugs for such purposes prior to FDA review or changes in labeling. This is referred to as "unlabeled uses" of drugs.
    A different problem arises when a particular use for a drug has been examined scientifically and has been found to be ineffective or unsafe, and yet physicians who either are uninformed or who refuse to accept the available scientific evidence continue to use the drug in this way. Such use may have been reviewed by the FDA and rejected, or, in some cases, the use may actually be warned against in the labeling. This subset of uses may be properly termed "disapproved uses."
    Government policy should minimize the extent of unlabeled uses. If such uses are valid? and many are? it is important that scientifically sound evidence supporting them be generated and that the regulatory system accommodate them into drug labeling. Continuing rapid advances in medical care and the complexity of drug usage, however, makes it impossible for the government to keep drug labeling up to date for every conceivable situation. Thus, when a particular use of this type appears, it is also important, and in the interest of good medical care, that no stigma be attached to "unapproved usage" by practitioners while the formal evidence is assembled between the time of discovery and the time the new use is included in the labeling. In the case of "disapproved uses," however, it is proper policy to warn against these in the package insert, whether use of a drug for these purposes by the uninformed or intransigent physician constitutes a violation of the current Federal Food, Drug and Cosmetic Act is a matter of debate that involves a number of technical and legal issues. Regardless of that, the inclusion of disapproved uses in the form of contraindications, warnings and other precautionary statements in package inserts is an important practical deterrent to improper use. Except for clearly disapproved uses, however, it is in the best interests of patient care that physicians not be constrained by regulatory statutes from exercising their best judgment in prescribing a drug for both its approved uses and any unlabeled uses it may have.
It can be inferred from the passage that the intransigent physician______,
选项 A、continues to prescribe a drug even though he knows it is not in the best interests of the Patient
B、refuses to use a drug for an unlabeled purpose out of fear that he may be stigmatized by its use
C、persists in using a drug for disapproved uses because he rejects the evidence of its ineffectiveness or dangers
D、experiments with new uses for tested drugs in an attempt to find medically beneficial uses for the drugs
答案C
解析 细节推断题。在第二段中作者认为有些医生坚持将被禁止过的药品用于医疗用途出于两种原因。即要么忽略、要么拒绝接受事实。在第三段中所指的那些医生违背药品使用规定，不是uninformed，就是intransigent。两段的内容使我们得知，intransigent physician指的是那些拒绝接受药品无疗效事实的医生。这与C的内容完全相符。A是错误的，因为intransigent physician所开的药是违反规定的。B不正确，因为这种医生不会去冒险。D的内容不符合问题所说的intransigent physician的定义，故是错误的。
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