To me, the major point of contention is this: do we need to have a fixed treatment end point, or can we have the flexibility to do multiple “n of 1” trials, as we call them? We look at whether this is working in a person. If they get 50% better, do we push it further? We need to exercise clinical judgment.
Another issue of controversy is whether or not the patient has a voice. We need to think of it in a way that's similar to cancer care. Would you say that we're going to treat all cancer in Canada with the same chemotherapy, no matter what organs are affected, no matter what stage, no matter what's happening? No. We have to look at the individual cases, the individual preferences, and tailor it there. That's what we're saying as family doctors.