Physician Patient

Archive for May, 2020

The Morality of Medical Practice

Tuesday, May 19th, 2020

This superb article by James L. Doenges, MD titled “Third Party” Interference, the Practice of Medicine, and the Market Economy” was originally distributed by the Association of American Physicians and Surgeons (AAPS) in 1959 and reprinted in the Spring 2020 edition of the AAPS Journal.
The morality of the practice of medicine is much older than its scientific basis. In the final analysis, says Dr. Doenges, “The patient-physician relationship …is made possible only through an appreciation of the moral responsibility of both individuals… No one can remove the personal responsibility of each to the other… The key to good diagnosis is good, honest, and complete history. The knowledge that information confided to the physician will not be divulged to others permits even the most timid patient to give the most personal, intimate, and confidential information to his physician…Medical care is not a mechanical function…Every “Third party” medical program is dishonest because through classification, fixed fees and regulations it indicates to all that illness can be standardized. This position is false because it ignores individual variations as diagnostic requirements, time, complications, circumstances of treatment, response to treatment, and severity of the disease. All medical teaching, tradition, and experience repudiates this idea…Third party medical programs inevitably result in falsification of records.”

Harm Reduction Strategies to Counter Opioid Addiction and Overdose Deaths

Friday, May 1st, 2020

https://www.cato.org/policy-report/march/april-2020/surgeon-generals-warning

In this Jan. 2020 talk, US Surgeon General Jerome M. Adams, MD, MPH outlines proven life-saving measures to reverse death and disability in the current US opioid epidemic. Training and equipping first responders (police, firefighters) as well as addicts themselves to use naloxone (Narcan) as an antidote to reverse respiratory depression which often kills in heroin, fentanyl overdoses, Dr. Adams also emphasizes the positive results of sterile needle exchanges as public policy. In drug using communities such as the US homeless population, needle exchanges do not reinforce addiction behavior. Rather, providing easy access to sterile (safe) needles permits personal contact by outreach helpers which can result in needed shelter and access to effective addiction treatment for homeless people. Sterile needles avoid transmitting HIV and other blood born infections (such as hepatitis) which are readily transferred from person to person by dirty needles. Furthermore, opioid addicts may benefit from taking the medication buprenorphine (Suboxone) under medical supervision when prescribed on an ongoing basis to reduce opioid cravings to reduce the liklihood of  inadvertent overdoses from street heroin which is often laced with lethal fentanyl.