sábado, 16 de enero de 2016

BioEdge: How much treatment do heroin addicts deserve?

BioEdge: How much treatment do heroin addicts deserve?

How much treatment do heroin addicts deserve?

American heart surgeons are making the difficult decision not to provide surgery to heroin addicts who present repeatedly with drug-induced heart valve infections.

number of stories in recent months have described in detail the doctors’ dilemma: having to chose between another heart valve replacement for addicts (sometimes costing more than US$500,000), or refusing to operate on them again. A heart valve replacement operation requires patients to abstain from drug use in the months following the procedure, but most heroin addicts are non-compliant.

Doctors feel that repeat operations are a poor allocation of healthcare resources. “This costs a lot of money,” says Scott H. Bronleewe, an experienced cardiac surgeon practicing in Tampa, Florida. “Six to eight weeks of a hospital stay and surgery probably amounts to over $500,000. Most if not all have no insurance coverage.”

Clinical ethicists say that doctors have no obligation to repeatedly operate on non-compliant patients. “If an individual isn’t going to change behavior and take responsibility for their life, the surgeon really doesn’t have an obligation to replace that heart valve a second or third time”, Dr James Orlowski, paediatrician and medical ethicist, said.

Many, however, believe that heroin addicts have limited responsibility for their continued use. Sarah Suzuki, a substance abuse counsellor in Chicago, believes that abstaining from drugs is not an easy feat for those with serious addiction issues.

“Contrary to popular belief, people who are addicted to heroin don’t experience a rush of pleasure or joy when they use”, she told Medill Reports early last year. “Rather, they stave off withdrawal symptoms and maintain a sense of equilibrium.”

Heroin use is on the rise across the US, according to statistics from the Centers for Disease Control and Prevention.

Sharon Kelley, CEO of Associates in Emergency Medical Education, called the issue an ongoing “ethical quandary for doctors”
- See more at: http://www.bioedge.org/bioethics/how-much-treatment-do-heroin-addicts-deserve/11717#sthash.5Dr44DMW.dpuf

In his State of the Union address President Obama announced a cancer moonshot: an ambitious plan to cure cancer. "The same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease," he said.
Oops. He didn’t say that. Richard Nixon did in his 1971 State of the Union address. “We want to be the first generation that finally wins the war on cancer,” then-Vice President Al Gore said in 1998. “For the first time, the enemy is outmatched.”
It’s not just the politicians who know how to cure cancer. Scientists make big promises as well.  In 2005 the Director at the National Cancer Institute, Andrew von Eschenbach, said “Our plan is to eliminate the suffering and death that result from this process that we understand as cancer, and we are committed to a goal of doing so as early as 2015.”
That commitment was made only ten years ago and cancer is still the second leading cause of death in the United States.
It’s great to feel optimistic, but one has the feeling that promises like these are made to distract voters from other issues. “It’s a bit utopian at this point,” agreed Barrie Bode, a professor at Northern Illinois University and a 20-year cancer researcher, told MarketWatch. “It’s like saying we need to fix the economy once and for all. Right, like that’s going to happen,” he said.
However, if you are looking for a job in cancer research, now looks like a very good time. 

Michael Cook



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