Following on from the discussion about euthanasia:
Many people will ask doctors to take courses of action which, if followed, would lead to harm. These range from requests for unnecessary operations to inappropriate and dangerous drugs. When should the doctor go along with the patient's request, and when should he refuse?
For example:
It is common for people to go to the doctor's with what is very likely a viral infection, and demand that they be prescribed antibiotics, despite the doctor pointing out that they won't do any good. Frequently doctors cave in and do prescribe antibiotics, and this has contributed to the emergence of antibiotic-resistant bacteria.
Similarly, there is a massive over-prescription of Ritalin and similar drugs in the States to young children, even though (AFAIK) the drug hasn't been medically tested on young children. The reason is that parents want to make their children easier to control, even if there's nothing wrong with them, without realising that they could be harming their children in the process.
Originally posted by AcolyteI agree, especially with Ritalin. I think a good amount is prescribed to help out lazy parents.
Following on from the discussion about euthanasia:
Many people will ask doctors to take courses of action which, if followed, would lead to harm. These range from requests for unnecessary operations to inappropriate and dangerous drugs. When should the doctor go along with the patient's request, and when should he refuse?
For example:
It is common fo ...[text shortened]... ing wrong with them, without realising that they could be harming their children in the process.
In our days where each and every one of us knows exactly how to treat every thing after watching 3 episodes of "ER" or one of the numerous medical soap-operas its probably quite difficult for doctors to convince their patients that they should trust them to know what is right. Further we can always say that we want a second oppinion - thus threatening with taking our business across the street.
However every doctor should do what they know is best for their patient and not what the patient (or patients parrents) think is best. Actually they have sworn to do so. In every of the contries that I have any knowledge of doctors are required to swear the Hippocratic Oath.
Below is the vertion of the Hippocratic oath that I first googled - I dont know if this is a good translation of the original. Certainly I would expect that a different version is used in most contries - e.g. exit greek gods, exit abortive remedies in most (western) contries.
Actually as a note to the euthanasia debate many doctors consider euthanasia impossible for them due to the 3rd section.
Hippocratic oath:
I swear by Apollo the physician, and Aesculapius, Hygeia and Panacea and all the gods and goddesses, that,
according to my ability and judgement, I will keep this Oath and this covenant.
To reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring on the same footing as my own brothers, and to teach them this Art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples who have signed the covenant and have taken an oath according to the law of medicine, but no one else.
I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked, nor suggest any such counsel; and in like manner I will not give to a woman an abortive remedy. With purity and with holiness I will pass my life and practise my Art.
I will not cut persons labouring under the stone, but will leave this to be done by such men as are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves.
Whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and practice of the Art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.
Nice point about ER.
People are getting more knowledgeable about diseases etc. therefore their doctors are under more pressure to prescribe what would make the patient feel more comforted.
Under the same heading:
What's your take on patients going to a GP with some problem and then asking the doctor to pad the prescription with some other chronic medication - "just to have it around, you never know"
Originally posted by Crowleyi love ER, i haven't missed an episode yet in all the time it has been around.
Nice point about ER.
People are getting more knowledgeable about diseases etc. therefore their doctors are under more pressure to prescribe what would make the patient feel more comforted.
Under the same heading:
What's your take on patients going to a GP with some problem and then asking the doctor to pad the prescription with some other chronic medication - "just to have it around, you never know"
Originally posted by AcolyteRitalin has NEVER been tested in a proper clinincal study for use on patients (of any age) with Attention Deficit Disorder (ADD) or as it is otherwise called Attention Deficit Hyperactivity Disorder.
Similarly, there is a massive over-prescription of Ritalin and similar drugs in the States to young children, even though (AFAIK) the drug hasn't been medically tested on young children. The reason is that parents want to make their children easier to control, even if there's nothing wrong with them, without realising that they could be harming their children in the process.
The medical faternity started prescribing Ritalin is the early 80s for ADD largely based upon circumstancial evidence and mostly because it was the latest drug the companies were pushing.
Very few people realise it is a stimulant. The idea of giving a powerful and very addicitive stimulant to someone who can not concerntrate seems and is counterproductive. In fact the medical community DOES NOT know how or why Ritalin may or may not work. Again there have been no physiological studies to find that answer.
This also raises another side point. ADD is very hard to diagnose. There is a list of symptoms which are used to help but each individual with the disorder is different. AND the recognised syptoms of ADD have changed over the last 20 years. So that many people who would be given Ritalin for ADD 20 years ago SHOULD NOT be given the medication today because it is recognised that they do not have ADD.
Furthermore there are recent studies which show non drug therapies produces better results than the use of Ritalin or other drugs.
Originally posted by AcolyteIs this a serious question?
[b]When should the doctor go along with the patient's request, and when should he refuse?
[b]
When should a doctor go along with a patients request? Never, that's when!
I can't believe a professional doctor would seriously cave in to his patients demands. That's absurd.
Originally posted by jimmyb270Oh, but they do. Look at the numbers of antidepressants, antibiotics and other things people think are 'magic pills' they hand out.
I can't believe a professional doctor would seriously cave in to his patients demands. That's absurd.
From http://www.managedcaremag.com/archives/0004/0004.finger.html :
"Antibiotics often are prescribed, studies have found, for viruses -- against which they have no effect. In a common scenario, a parent takes a sick child to a physician. The doctor determines that the child's illness is due to a viral, not a bacterial, infection. Because there is no treatment for the viral infection, the doctor tells the parent to let the virus run its course and perhaps to try some over-the-counter pain medication. But the parent feels entitled to get something out of the office visit; being told to let the virus run its course isn't satisfactory. The parent insists on a prescription for an antibiotic and may even threaten to find a physician who will write a prescription. Feeling pressured, the physician may write an unnecessary prescription for an antibiotic, even though it will have no positive effect on the child's illness."
"Doctors believe they have to send patients away with a prescription, or [patients] don't feel like they got their money's worth. All of us are taught to say no, but we get a lot of pressure from patients. Whether right or wrong, doctors prescribe medicine over the phone because it's just the nature of the beast." (Thomas Moore, senior fellow, Center for Health Policy Research, George Washington University Medical Center, in USA Today.)
Originally posted by AcolyteUnfortunately this happens all to often. It does really require an extensive education campaign to educate the general public on the health dangers of over prescribing anti biotics.
"Antibiotics often are prescribed, studies have found, for viruses -- against which they have no effect. In a common scenario, a parent takes a sick child to a physician. The doctor determines that the child's illness is due to a viral, not a bacterial, infection. Because there is no treatment for the viral infection, the doctor tells the parent to let the ...[text shortened]... tion for an antibiotic, even though it will have no positive effect on the child's illness."
Personally if my GP tried to prescribe anti biotics to my or my family for a viral infection i would never return to that docotor again. I would also write a ciomplaint to the medical board. It really is that serious of a problem.