Monday, July 26, 2004

I'm Back

Just finished the corrections for the final draft. Able to exhale now. Unfortunately, I missed the discussion about Ms. Richards' and Ms.Ehrenreich's articles. I did, however, manage to read one excellent relevant post at Mouse Words (via ampersand). Actually, I managed to read a number of other interesting posts there, on the economics of beauty, and the maternal/fetal issues raised by the apparent murder of a pregnant woman.

I also found this scary article Feds Alarmed at Internet Rx Sales. I'll come back to this piece in a second, but first I wanted to mention a related snippet I saw last night on NBC (I think it was Dateline).

The intrepid reporter enters false health info (the height and weight of her dog--something like 4 feet and 20 lbs) while ordering rx meds (Prozac or Valium, didn't catch the exact order) from an on-line pharmacy. Then she tracks down the physician who approved the order, travels to Europe (? The Netherlands) to talk to him, and confronts him about her order. As so often happens in situations like these, the doctor was unbelievably inarticulate (granted, apologetic, but still). At no time does he ask the reporter why she supplied incorrect information, and then, having done that, why she expected to receive proper care? Or why should she not assume any responsibility for her action? Here we have a very important topic--lay people wanting, and being able, to self-medicate--that merits a lot of serious and nuanced discussion, and all we manage to learn from this interview is that the reporter is a good trickster. What a squandered opportunity!

However, fear not. If we (patients and health-care professionals alike) can't muster up enough brain power to conduct ourselves in a manner benefiting our best interests, our "beloved" leaders are ready (and eager) to step in. Which brings me back to the article I mentioned. Here are the first two paragraphs:

Americans are purchasing billions of dollars worth of prescription drugs over the Internet with no guarantee that they are safe, effective, or even real, federal investigators tell lawmakers.

Law enforcement officials also say they are now basically powerless to stop the flood of prescriptions -- many of them illegal -- arriving in the U.S. from foreign countries in millions of mail shipments.


And there you have it! This has nothing to do with your health, or concerns over your well-being. It's all about the government losing control over your thoughts and actions. Think I'm being a tad over-dramatic? Perhaps; however, when it comes to the doctor-patient relationship and the ability of individuals to act in their own best health interests, I am a purist. Read the justification for nanny-ism offered by a homeland security (really, homeland security for Prozac?) official, and tell me you don't feel insulted and infantilized:

"This is not just getting the same drug at a bargain price. There are risks," says Richard M. Stana, a homeland security and justice investigator with the General Accounting Office, the investigative arm of Congress.

(Emphasis added.) Um, yes, obviously there are risks involved in ordering (and taking) meds from an unknown source. There are also risks involved in crossing the street, becoming pregnant, driving a car, taking aspirin, and making love. The beauty (read responsibility and reward) of being a competent adult is that we are able to conduct a "risk/benefit" analysis and decide for ourselves what is in our best interest. Of course, we may (and we should, and often do) consult relevant professionals to help us with our decisions. But, at least when it comes to medical decisions, politicians, and government officials and administrators should not be the ones in a position to decide what's best for us.

Finally, look at the listed sources for this article:

SOURCES: Sen. Carl Levin (D-Mich.). Richard M. Stana, director, Homeland Security and Justice Team, General Accounting Office. William Hubbard, FDA associate commissioner for policy and planning. Karen P. Tandy, administrator, Drug Enforcement Administration. Sen. Norman Coleman (R-Minn.).

Where is the input from patients/consumers, physicians/nurses/pharmacists, family members, etc.?



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