Ethical principles relevant to the use of aspirin as a treatment of cancer

There are four basic ethical principles in clinical practice: non-maleficence; beneficence; autonomy and justice. Evidence upon which each of these is judged comes from appropriate research, but there are also personal opinions and claims – many of which are supported by little, if any, research evidence. The evaluation of evidence is likely to be assessed differently by the different operatives involved in any clinical issue: pharmacologists, pharmacists, clinicians, oncologists, research workers, patients and their carers.

In the case of aspirin as a possible treatment of cancer, there are three possible beneficial outcomes to be considered: a reduction in thromboembolism; a reduction in metastatic spread and a reduction in cancer mortality. The main risk is an increase in gastrointestinal and cerebral bleeding associated with aspirin use.  

This paper attempts to summarise the evidence from research on these risks and benefits.