tag:blogger.com,1999:blog-7323692122514281455.post8146492842119924598..comments2024-03-22T17:05:55.267-04:00Comments on MD Whistleblower: Why Medical Ethics Should Matter to PatientsMichael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-7323692122514281455.post-6416681408170505862011-02-05T13:50:25.629-05:002011-02-05T13:50:25.629-05:00Excellent points re compartmentalization of medica...Excellent points re compartmentalization of medical care. Soon, we'll have medical specialists such as a retinologist, for the left eye only!Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-77838198189421011292011-02-05T12:11:17.641-05:002011-02-05T12:11:17.641-05:00As a patient I have seen a decline in patient care...As a patient I have seen a decline in patient care. I find it hard to believe that physicians actually dispense drugs so freely, without thought. For example, not everyone's high cholestrol is caused by the same thing. While some may have it from being overweight, another might have it because of an inflammatory response from an infectious disease that doctors never treat. Doctors also compartamentalize the body. I know someone who had visual problems and a blue toe. Why can't physicians see a relationship between the two? Instead, they sent the patient to a podiatrist and eye doctor. Years ago (25 years ago to be exact) doctors treated in most cases on the basis of symptoms and cured people. There were never these extensive tests. They knew immediately whether something was intestinally caused or whether there were other factors, just from the symptoms. And they hardly ever prescribed pharmaceutical drugs. As a patient I think this is happening because there are too many doctors. The more doctors, less profit, and more compartamentalization of the body so all doctors profit. Pharmaceuticals are given too readily. All you physicians ought to be watching Dr. Oz who, because he's no longer practicing among you, can speak about actual healing. Don't get me wrong. I am not entirely against pharmaceuticals; but they should be prescribed for seriously ill patients only, like someone who has a cholesterol reading of 400 or something like that. Dr. Oz' remedies for lowering cholesterol actually work. Since watching his show I only eat at home now and I lowered my cholesterol dramatically.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-71243658036830267622011-01-29T11:49:43.001-05:002011-01-29T11:49:43.001-05:00Michael,
Love your work. Would love to feature y...Michael, <br /><br />Love your work. Would love to feature you on THCB. Alas, no contact info? Drop me an email or skype me if you'd like to chat. John Irvine, Executive Editor THCB. el.irvine at gmail dot com. skype - skypejibJohn Irvinehttp://www.thehealthcarebog.comnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-3557204661372270042011-01-27T02:09:31.756-05:002011-01-27T02:09:31.756-05:00Snaps to Dr. Fogelson for actually tackling these ...Snaps to Dr. Fogelson for actually tackling these ethical questions with answers. I was left pondering some of them. Great post, Dr. Kirsch.Toni Brayer, MDhttps://www.blogger.com/profile/15258759363309666629noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-43928718663010337662011-01-25T15:10:32.729-05:002011-01-25T15:10:32.729-05:00People tend to view philosophy (of which ethics is...People tend to view philosophy (of which ethics is a part) as strictly academic rather than practical. However, it is very practical for physicians and others to think very hard about what their personal philosophies are in order to cope with situations that develop. Once one has developed a code of ethics and thought about what situations may develop that require ethical decisions, making those decisions when it is time is a whole lot easier.Michael Endershttps://www.blogger.com/profile/15894626514847673764noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-11458908230496895522011-01-24T19:53:53.217-05:002011-01-24T19:53:53.217-05:00I heartily agree with Dr. Fogelson's assessmen...I heartily agree with Dr. Fogelson's assessment of medical/bioethicists who hold themselves out as the sole qualified voice to answer these sorts of questions, or even the "bigger" questions.<br /><br />What I find disturbing about the bioethics establishment is the way in which its mainstream seems to be lined up squarely against any meaningful notion of patient autonomy, or treating non-physicians as somehow entitled to information about and control over their own health. <br /><br /> I actually just posted something to this effect yesterday, taking the lens of public-choice theory to professional medical and bioethicists. Quis custodiet ipsos custodes?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-90879286136027433982011-01-23T15:47:33.845-05:002011-01-23T15:47:33.845-05:00Nick, outstanding response! No wonder you were th...Nick, outstanding response! No wonder you were the winner of my Grand Rounds!Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-88410924640561305642011-01-23T12:19:29.032-05:002011-01-23T12:19:29.032-05:00I had a detailed response and then it got lost whe...I had a detailed response and then it got lost when I accidentally clicked a link.<br /><br />In short, ethics are plastic over the span of time, defined by the predominant belief of our society at that time. They are also different from society to society in the same time. People in the past are ridiculed for having been unethical, which isn't really fair given the ethics of the time in which they lived.<br /><br />I am struck by ethics 'experts' who claim to have a monopoly on truth, as they have no more right to it that anyone else. They may be able to define the language under which we will debate, but have no more right to the answer than any man or woman.<br /><br />As for the questions, I have my own answers, which have the value of one human.<br /><br />A) schedules are plastic, like ethics. See them both.<br /><br />B) There is no doctor patient confidentiality between the doctor and the patient's wife. That said, a wise person would find a way to get this information from the patient without revealing anything. Perhaps watch a little "Lie to Me" and find out how its done.<br /><br />C) Nope. Have to care for the patient unless there is an appropriate covering doctor or formal firing process has gone on.<br /><br />D) Not unethical. The cost of providing samples is one of a zillion costs the drug manufacturer has in producing drugs. Its it unethical to pay the chemist at Pfizer? The Janitor? Their salaries increase the cost of providing drugs to patients too<br /><br />E) It is neither ethical nor unethical. No one has an ethical requirement to testify against another, unless subpoenaed by the court. It is the plaintiff attorney's job to make the case, not the physician in the third party.<br /><br />F) I don't know. I want to say that a physician is a private contractor, and unless under other contract with a third party, can see whoever he or she likes, just like any other businessman. The question to me is motivation. Does this physician have such an ego that he can't handle the fact that maybe somebody wouldn't follow his advice? Patients are not beholden to their physician. They pay (or a third party pays) for the physician's best advice. The doctor works for the patient, not the other way around. So I guess _unethical_ then.<br /><br />G) If the physician believes that the patient was disabled, yes its fine - but he can't write down things that he cannot verify to be true. It is not ethical to fabricate a story to please the patient. Forget ethics, its fraud.Nicholas Fogelson, MDhttp://www.academicobgyn.comnoreply@blogger.com