I tried to discuss this with oncologists, not organ transplants but the idea of controlled failure to buy time. They only cared about protocol etc etc..
The short version is that a psychiatrist noticed there's a screening test for bipolar disorder which is used without any solid study backing it up. He proposed running a test; give a bunch of patients formal, full-length diagnoses, give them the screening also, and see how often they match. This is the easiest thing in the world. Both the screening test and the full diagnostic were already in use, and could be deployed without any justification. The only 'study' here was to do both and compare them.
Except. Except that this is medicine, and it's overseen by IRBs, not doctors or researchers, and there isn't a non-study treatment plan in the country that would stand up to the rules of IRBs. After a year of bureaucratic crap, our intrepid protagonist managed to scrape together a study-worthy amount of data. And then it got audited, and after another nine months, was halted for an impossible-to-fulfill list of idiotic revisions.
That was to administer an already-in-place questionnaire, without using it for diagnosis. I'm pretty sure the assignment "experiment with controlled failure in cancer patients" would drive most IRB victims to quit medicine and become subsistence farmers.
(I'm on a soapbox here, I know, and I'm sorry. It doesn't make the idea bad. But I have a lot of sympathy for why doctors would respond to research ideas like they're being asked to wrestle a tiger.)
recently there was a piece saying oncology should get a bit back to early days strategies. less bureaucracy, less layers and instead more science and more care.
