Doctors Don't Always Get to Bury Their Mistakes

One question - who allowed this to happen?  "This" is the oxycontin addiction plague that has swept through northern native communities and may leave enormous suffering in its wake when the drug is abruptly removed from distribution next month.  Oxycontin, the so-called "hillbilly heroin", drug of choice of addicts like Rush Limbaugh.

It is reported that some northern communities have oxycontin addiction rates in excess of 50% of the population.   Imagine half a village facing opioid withdrawal at once.

Getting doctors to prescribe opioids more appropriately needs to be part of the solution, because many of them may just unwittingly switch their patients to other equally addictive drugs, such as hydromorph contin, fentanyl or morphine, said [Dr. Meldon Kahan, medical director of addiction medicine service at St. Joseph’s Health Centre in Toronto] .

Hydromorph contin, for example, provides a sustained release of hydromorphone, which like OxyContin can be crushed, injected and is fully covered under the Ontario drug benefit plan. 


“This is a very unusual public health crisis because it was generated by the medical system,” said Kahan. “Doctors' knowledge of this is not very high, because they don’t get much training on it.”

Say what?   Don't these doctors read newspapers or watch shows like 60 Minutes that has run exposes on OxyContin abuse?  If the general public knows the perils of this drug any doctor who claims he doesn't is either incompetent or a liar.


Affixing blame is necessary to prevent this happening again.  It's part of fixing a system that is very plainly broken.   That said, someone has to take responsibility for the addiction nightmare that will be sweeping the north in just a few weeks.  If we have any claim to being a civilized society, we just cannot leave these addicts to their fate.

Maybe it's time the medical profession took responsibility for the failure of its own members.   They want to be a self-governing profession.   That privilege comes with responsibilities to society including overseeing the standards of practice and the continuing education of members.   It was members of the medical profession who earned fees writing these prescriptions and we expected them to act responsibly when we granted them that authority.   A good many of them obviously abused that privilege and now they and the profession that failed to regulate them should make good the suffering in the north.

How Do You Possibly Defend this Lawsuit?

Let's say that you had a new antibiotic.   And let's say that you wanted to find out if it was effective against syphilis and gonorrhea.   And let's say that you figured the best way to test it would be to infect another country's prisoners and mentally ill with those diseases without their consent or knowledge.

And then, many decades later, all this comes out and you have to apologize for what even you call these "reprehensible" experiments.

These events happened in Guatemala from 1946 to 1949.   Now lawyers for those survivors and the victims' families have given US attorney general until Friday to indicate if Washington is willing to settle this out of court.  If not, they sue.

What can America possibly do except settle?   They might be able to come up with procedural or jurisdictional defences but the political costs, domestically and internationally, would be gargantuan.   The report that broke the decades of silence, written by Susan Reverby, is riveting.

Bring Out Your Dead - Just Not Now

When is "dead" not really dead? That's an issue tackled today in the National Post.

The question revolves around the point at which helpful hospital staff can begin playing pickpocket with your internal organs, harvesting what they can for recycling in some other poor soul. The article warns of a "trend" of stripping organs from patients who have suffered cardiac death - no pulse - but may not yet be truly brain dead. Get'em while they're fresh!

Trouble is, you see, stopped hearts can sometimes be restarted. I know. Sometimes it's the paddles, sometimes it's a shot of adrenalin straight into the heart. But, surely, should the medical team not give up the ghost on us until we've really given up the ghost ourselves?

Dalhousie medical ethicist Jocelyn Downie has written a paper in which she suggests medical staff may be breaking the law in their rush to help save other patients from mortal illness.

The cardiac-death protocol, meanwhile, should probably be halted until more is known about when someone whose heart has stopped is beyond recovery, Prof. Downie said.
"We need clarity around this because it is critically important for a host of reasons," she said in an interview.
"It's only after the declaration of death that certain things can happen: We can take your organs, we can bury you, we can do an autopsy ... we can trigger all sorts of things around your property."

Who knows, is this next? -