# When a Medical “Cure” Makes Things Much, Much Worse

Discussion in 'Ethics, Morality, & Justice' started by sculptor, Jan 3, 2018.

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3. ### spidergoatValued Senior Member

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Have to get for what? To end modern medicine?

5. ### sculptorValued Senior Member

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"medical industrial complex"

7. ### spidergoatValued Senior Member

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What about it? Make an argument.

8. ### DaveC426913Valued Senior Member

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Interesting, modern pharmocology itself is only about as old as the event in the article. I wonder if they could have used an example that is less than a half century old...

This may be an example of the Nirvana fallacy. Are you suggesting throwing out the whole thing because parts of it are not perfect? (Note: that is not an unwarranted assumption on our part, since have left us to guess what your argument is.)

I'd be more interested to see an argument that weighed the risks of having modern pharmacology against the risks of not having it.

Frankly, imperfect as modern medicine may be, I'm thankful that it has granted me a life expectancy as much as double my ancestors, and has granted my potential children a vastly reduced mortality rate.

Last edited: Jan 7, 2018
9. ### iceauraValued Senior Member

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Too much credit to medicine, especially drugs - also, slipshod statistics.

10. ### Xelasnave.1947Valued Senior Member

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I like Jelly beans.
Step back look at the big picture even if a percentage works and it helps we are ahead.
Alex

11. ### exchemistValued Senior Member

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Can you show why these stats are "slipshod"?

12. ### originTrump is the best argument against a democracy.Valued Senior Member

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It is quite possible (I don't know) that the increase in life expectancy and decrease in infant mortality is due in large part to better nutrition and agricultural practices.

13. ### exchemistValued Senior Member

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Oh yes I see what you mean. Better nutrition, better sanitation and less pollution will all have contributed.

I wouldn't say however the stats are shown to be slipshod, only that it would be slipshod to attribute the improvement they show solely to medicine, and within medicine, to drugs. I read somewhere that antibiotics are thought to be responsible for an 8yr improvement in life expectancy between 1945 and 1970, or something like that.

If you consider all the other drugs that prolong life and reduce morbidity, it might seem reasonable to attribute say a 10-15yr improvement in life expectancy to drugs overall, maybe. Which is not to be sneezed at.

14. ### originTrump is the best argument against a democracy.Valued Senior Member

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Agreed the stats are fine. There are 'wonder drugs'. I would have died without antibiotics - I came close anyway. My son has had pneumonia 3 times as a toddler - he probably would not have made it either without antibiotics.
I do think however that there are drugs where the side effects are so drastic that they are not worth taking. I am thinking of cancer drugs that extend your life for a few months and burn through all of your savings and make you sicker than hell for those few months.

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15. ### exchemistValued Senior Member

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Hmm, I see what you mean and I do realise you are talking from a US viewpoint, where commerce and medicine are perhaps somewhat unhealthily intertwined. Speaking as a Brit, we get issues about the non-availablity of drugs like that on the National Health Service, because new treatments have to be weighed up on a cost/benefit scale by a board called NICE (National Institute for Health and Clinical Excellence) and the most doubtful, in terms of high cost or weakness of benefit, don't make the cut. So then we get sob-stories in the papers about some doe-eyed kid who wants to see another Christmas but won't because of the "evil accountants" or "savage Tory cuts", according to your political preference.

But someone has to make the call: money is not unlimited.

My wife got treated, towards the end of her cancer, privately and at vast cost, with a couple of experimental drugs (pre-NICE approval) , but the oncologist was quite wise in counselling about the benefits versus the side effects. Nothing she was given had a drastic impact on her quality of life, and perhaps we were fortunate that it was obvious when her time was up and we didn't fight it. The only procedure that I think was arguably a waste of (NHS) money was the artificial intravenous feeding programme, when her digestive system gave up completely (it was ovarian cancer). That cost a lot to set up and calibrate for her, we had loads of equipment delivered to the house and nurses to operate it, and in the end it only bought her another 10 days or so. With hindsight we should probably have said "game over" a bit sooner.

But that was the only thing I think we might have done differently. The oncologist and her drugs kept her going, with full enjoyment of a busy working life, for at least five years longer than she would have lasted without them. And when you are bringing up a kid, those years are invaluable. So I am rather impressed with what drugs can do.

16. ### originTrump is the best argument against a democracy.Valued Senior Member

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First of all I am so sorry for your wife and family, what an ordeal that must have been, I can't imagine. I am very glad that the treatment was helpful.
I suppose this comes down to personal experience. My wife's best friend died of breast cancer and it seemed that the drugs that they gave her kept her bed ridden for about 6 months until she died. It really really really sucked. But I am not a doctor so for all I know the drugs helped and it was the god damn cancer that was the real culprit.

Well the one thing that is sure is that the US has one god awful health care system and I don't see it changing for the better anytime soon.

17. ### C CConsular Corps - "the backbone of diplomacy"Valued Senior Member

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Ridiculous. You're surely not suggesting that the actual source of any _X_ medical-induced epidemic be addressed and held accountable, or that doctors and the pharmaceutical industry should turn back the clock to a naive, less bold or more cautiously conservative era. It's the responsibility of patients to follow instructions and regulate any excessive desires and needs arising from the drug approach to treatment and remedy (including pain). At most, the clinical community might provide them with a little counseling but certainly not mitigate the cash-flow gushing out of the prescription spigot.

Modern prescription opiates such as vicodin and percocet entered the market in the 1970s, but acceptance took several years and doctors were apprehensive about prescribing them. Until the 1980s, physicians had been taught to avoid prescribing opioids because of their addictive nature. A brief letter published in the New England Journal of Medicine (NEJM) in January 1980, titled "Addiction Rare in Patients Treated with Narcotics", generated much attention and changed this thinking. A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis. The NEJM published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home. The original author, Dr. Hershel Jick, has said that he never intended for the article to justify widespread opioid use. (Opiod epidemic)​

Hah. Exaggerated melodrama, bloated histrionics. These types of headlines below are just fear-tactics for bumping up the media's own rankings. They don't even deserve ascription to whatever broader, complex agendas that the other sides' own crank manipulators concoct and project.

Opioids could kill nearly 500,000 Americans in the next decade
Opioid history: From 'wonder drug' to abuse epidemic
Regardless of whether it’s $504 billion or$95 billion, these costs of the crisis are far higher than what we’re spending on prevention and treatment

- - -

18. ### iceauraValued Senior Member

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Just the ones posted.

Quick overview: They show nothing but time correlations, they aggregate without explicit regard for the factor they purport to inform (entire continents treated as blocs of medical care, etc), they treat correlated and dependent factors (childhood mortality and expected lifespan at birth or of parents, say, or mortality statistics in coupled regions ) as if they were independent, and so forth.

In more detail, one can point to things such as the various known factors other than local medical care whose fine structure would likely produce the visible coarse data - public health and sanitation, female education, reduced prevalence of epidemics and vector-born diseases in places near or neighboring better prepared setups, etc.

Modern medical care is a wonder, I'd be dead without it, but its share of the credit for generally increasing expected lifespans is not easily or carelessly calculated. That's all I meant to point at.

Last edited: Jan 9, 2018
19. ### exchemistValued Senior Member

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Well it wasn't so bad because the drugs kept her well until the last 4-5 months. That's really my point. Effectively she had an extra 5 pretty good years - even if it was clouded by the knowledge that it would all come to an end at some point. But evidently it depends on the case and the person. She tolerated carboplatin very well, which was a godsend, as it is still one of the standard chemo treatments, even after 30-40 years of use.

20. ### birchValued Senior Member

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i don't know if this could bring you comfort but these stories are based on extraordinary accounts that people have experienced. one is a possibility of souls/consciousness that doesn't die after the physical death but just moves on/transitions and even a better silver lining, perhaps you can see them again in the afterlife (the existence beyond this one) when you pass.

i think these stories/experiences can bring hope to people as it's a window of what could possibly be that there is more beyond the veil (what we think is the only reality).

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21. ### exchemistValued Senior Member

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[/QUOTE]
Thanks for the good wishes Birch, but I think that sort of thing is a product of the psyche of those left behind - and those (e.g. you!) disposed to comfort them. I was brought up Christian and I continue to regard the traditions and teaching with respect and affection, but my view now of Cartesian dualism - and hence of the soul and the afterlife - is that these are not real. Before we married, my wife raised this topic and said she thought that after you die "it's just worms", to which, with some relief, I agreed. But I gave her a proper requiem mass, just as we had had a proper nuptial mass 15 years earlier. With the same singers and some of the same music, in fact, as a way of completing the circle.

But we digress from the thread topic.....

22. ### exchemistValued Senior Member

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Yes, I see what you mean - very much as Origin and I have been discussing, in fact.

23. ### birchValued Senior Member

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okay, take it how you want. just something to consider.