Current articles and editorials on medical malpractice suits and the physicians dilemma are most interesting, but one aspect of the situation has escaped attention—the patient’s dilemma.
Not many doctors are aware that many of their patients, particularly the elderly, live in a state of quiet desperation and fear, afraid of the very persons on whom they must rely for healing.
Older people, for various socio-economic reasons, tend to live in communities with their peers, and they are acutely aware of what occurs daily among their neighbors.
Mrs. X has an eye infection. Her trusted doctor informs her she has a severe condition and that he will use a new drug. Two days later her pain is intense, her face swollen.
Now her doctor informs her she is allergic to this new drug and takes her off all medication. The condition heals itself. However, damage has been done and she will never see quite so well again. Mrs. X has a dilemma, to be sure. She has impaired vision.
Mrs. Y has been seeing her doctor regularly for 25 years having a thorough examination every six months. She has been a good wife, mother, never smoke or drank or indulged in any degenerative practice. “Suddenly” she has a heart attack.
After several weeks she recovers sufficiently to return home from the hospital. Three weeks later, in self-examination, she discovers a lump in her breast, whereupon a massive mastectomy is performed. Discharged after what is termed “successful” surgery, she has another heart attack, more hospitalization, followed by two years of semi-invalidism with many angina attacks.
Perhaps rightfully, she wonders “why?” Why hasn’t she, in all these years, received some counsel from
her physician in preventive methods?
Mr. Z goes to the hospital, a victim of drug overdose. He was taking a prescribed heart medication in the prescribed dosage.
He almost joins the “up to 140,000” who die each year in hospitals as a result of drug overdose under the “care” of licensed nurses and physicians, a fact reported by a spokesman for the American Medical Association (AMA) last year before a Senate committee. The committee also heard testimony that 80 percent of the deaths were preventable.
Even more shocking was the article in the Washington Post on May 24, 1974, which cited evidence indicating that 30 to 40 percent of all hospital patients suffer from adverse drug reactions.
In Los Angeles County a study showed that, of 50,000 prescriptions written, 13 percent were in amounts in excess of the maximum amount needed for ordinary therapy. The computer revealed that one patient had been given 54 prescription drugs in 112 days!
I have before me a copy of the Merck Index of drugs and it is a formidable volume containing more than 10,000 drug formulations to choose from.
The thought occurs to me that no one person could conceivably know all there is to know about these drugs. Furthermore, as a graduate chemist, I wonder how it would be possible even to predict what certain combinations of drugs would do within the the human body.
And yet, I know of a patient who received 26 different drugs in a single day! The potential in this chemical madhouse would confound the most learned biochemist, to say nothing of the human body thus impregnated!
The indiscriminate giving of drugs and combinations of drugs by anyone is tragic in the light of the accepted fact that the biochemical knowledge at our disposal today is rudimentary. The stupidity, thus, of giving numerous drugs in unproven combinations is enormous.
Is it any wonder so many elderly and less elderly patients succumb in a hospital? Such a situation poses an interesting problem for the legal mind. Are such deaths murder or manslaughter?
When and at what point does ignorance cease and responsibility begin? Should the physician be required by law to inform his patients that a particular drug has been known to cause death in other patients under similar circumstances? Should the physician be limited only to those drugs that have been shown in double-blind tests on a sufficient number of patients to be instrumental in cure and not in death?
When one adds to the drugged victims the startling reports published recently in the San Diego Union that as much as 20 percent of the surgery performed in this country is done by incompetent doctors, the tragedy mounts in its implications as does the fear among patients.
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Dr. Jean Mayer of Harvard cites figures from the World Health Organization which show that the U.S. has dropped from 11th place—just 25 years ago—to 37th place in health care standards among the civilized nations in the world. Roger Rappaport in his article, “It’s Enough To Make You Sick,” states that our vaunted medical know-how has “failed to keep our male life expectancy rate equal with that of nations that have considerably lower per capita incomes.”
Other evidence shows we have more heart trouble, more cancer, more diabetes and other so-called degenerative diseases than in any other country where statistics are available. Cancer is the number one killer of our children. As a nation we cannot afford this tragedy.
The facts suggest that the medical fraternity may have failed in its sacred trust. It may be that this period in time will become known as the Dark Age of Medicine.
Reprinted from the March 5, 1975, edition of the San Diego Union.