medical ethics: cure vs. treatment given capitalism.

Discussion in 'Ethics, Morality, & Justice' started by wesmorris, Sep 17, 2007.

  1. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    A medical company does what is in its best interest as long as it's free to do so. This is its mandate. It's "for-profit" which I believe it should be.

    Of illnesses that could be potentially "cured", what is the motivation for a medical corporation to do so? It's obvious that a treatment plan is much more profitable to the corporation than curing anything.

    This dilemma really confounds me. I can't figure an optimal way out of that predicament. The real problem is that as such, research dollars can't be really put towards "cures" even though they're all billed as such. Man this just puts my brain in a pickle.

    Ultimately, if all were responsible consumers and there was no insurance, or only major medical... perhaps cures will be demanded once past some random point in technology.

    I'm sorry, I really should look up some information about how many diseases have been cured in the last 60 years and stuff before I talk about this. Yeah pardon. I'll try to remember to do that.

    I still don't think the motivation is there for curing anything, and I'm not exactly sure how to set up a system to provide it.

    Someone school me fo reel.
     
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  3. joepistole Deacon Blues Valued Senior Member

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    You bring up a very interesting point and we are seeing evidence that this is adversely impacting healthcare in the United States. The best example are the drug companies. They are investing in tweaking existing drugs for existing conditions in orde to extend patent protections (eg. recent drug combining Lipitor and a Blood Pressure Medicine...dont remember the name off hand) extend patents on those drugs and advertising and marketing. They spend more on advertising and marketing than on research.
    In speaking with my physican a few weeks ago we discussed this very issue. It is likely that if research is allowed to proceed, gene therapy will replace a large segment of the drug maket in the next 10-20 years. In fact we already have the technology. Gene therapy will cure rather than manage a conditon...much less profit for the drug company. So given our govenment and the power of drug companies, gene therapy treatment may be delayed and impeded...kinda of like importing Canadian drug. We just don't know how safe those Canadians are with their prescription drugs. You know those socialist guys like all of our other big trading partners.
     
    Last edited: Sep 17, 2007
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  5. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    so are there rules we could construct that would motivate cures to be sought?
     
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  7. cosmictraveler Be kind to yourself always. Valued Senior Member

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    There have been many "cures" and more ways to control diseases and other problems in the last 50 years than in most time before this period IMHO. Just because one disease is cured , Polio for an example, doesn't mean that they all can be cured because of mitigating circumstances like virul mutations or cross contamination. True that the drug companies are looking out for profits but I believe that if a cure could be found they would release it for there are many diseases and problems out there, new as well as old, that still need to be cured.
     
  8. Grantywanty Registered Senior Member

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    Just to broaden the problem.
    1) not only is there less pressure to cure, but there is less pressure to avoid marketing drugs that cause long term problems: for example immunosuppression, which many over the counter and presciption drugs do cause. In terms of profit immunosuppression is actually a plus.
    2) the large companies use their PR departments to wage information wars on alternative methods. They make sure that any problem with an alternative (non patentable) method is highlighted in the news and any problem with their companies solution is downplayed. They even hire people to disrupt online alternative medicine discussion sites adn forums - some more politely and scientifically than others.
     
  9. Tiassa Let us not launch the boat ... Valued Senior Member

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    Wes, one thing that occurs to me is that nature abhors a vacuum. Even if we cure cancer, something will find a way around the cure. If we ever manage to destroy HIV and eradicate it from humanity, nature will respond with something new.

    Perhaps this notion is lost on pharmaceutical CEOs, but consider Viagra. The lesson there is that even if humanity beats cancer and AIDS, there will always be a market for boners and birth control. When they come up with a cure for anorgasmia, the pharmaceutical companies will see massive profits driven by black-market diversions. While chronic or congenital anorgasmia is rare, and frigidity requires psychiatric consideration, people who don't need it will abuse that drug at record rates.

    And they really do need a better pill for shyness. Isn't one of the side effects of the shyness medication explosive diarrhea, or something like that? I mean, how is that going to help people with shyness? And why do we have a pill for shyness, anyway? What the hell is up with that?

    Soon there will be a pill that replaces deodorants, and then all sorts of pills and therapies to treat the side effects of changing your body chemistry to give your pits the fresh scent of lavender and mint (Mintepit®). And whence comes that pill from The Simpsons, to make your bowel movements smell like fresh cinammon rolls?

    And then, at some point, the pharmaceuticals will move into cybernetics, curing blindness by just popping super-enhanced optical units into our sockets. (Microsoft, too, will make a bloody fortune so that we can get banner ads delivered straight to our visual cortex.)

    You raise a good question, and one that illustrates a difficult decision: Are they sinister, or just stupid? If they're sinister, it's because either there's something wrong with them (why don't they make a pill for that?), or they just haven't thought it through. Hence, the quesiton becomes, Are they stupid, or just ... er ... stupid?

    Theoretically, evolution should be the motivation to cure diseases, but if evolution is bad for the economy, rest assured that ForestGlaxoLillyNordiskAdNauseam will eventually make a pill for that.
     
  10. Pandaemoni Valued Senior Member

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    I would think that competition could handle this in many cases. If medical provider A is offering a palliative, but no cure, and medical practioner B is offering a cure, ceteris paribus which one would you go to? So long as the supply of the afflicted isn't likely to dry up, provider B is not disincentivized to offer the cure. Even if supply seems likely to dry up, if B decides to sell the palliative, the medical providers C, D, E, ..., etc. might sell the cure. B would then make no money.

    Admittedly, in some cases, there is enough collusion (tacit or otherwise) or you have an issue of monopoly power (as with any drug that has a patent outstanding on it), but that's true in many arenas. (Built in obsolescence has always been an issue.)

    The problem is that capitalism is the worst system for the provision of goods and services, except for all the others.

    The best I could offer is that you need philanthopists to offer prizes for companies/people that develop honest to God cures, rather than palliatives.
     
  11. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    This however, requires demanding and knowledgable consumers - I mean for competition (especially in this industry) to be effective? For instance, if all the consumers use $10 copay medical insurance - they don't care what costs are. This encourages "big deals", which seems to me that it pretty much induces the collusion you mention below.

    Ah, intellecshual propertease. I've been fairly convinced for some time now that patent law is a bad idea, ultimately inhibiting markets, but I'm not sure I'm right.

    Which are really capitalism with different laws, regulations, etc. Communisim is capitalism as far as I'm concerned, concentrated to the party elites, cronies, etc.

    Hmmm. Yeah the money that could be offered as a prize would seem to generally pale in comparison to the money garnered from palliatives (borrowing your word, unfamiliar with it). Awe yeah jack you get your money on the comeback. Drug dealing 101. The prestige might motivate some, but I'd think whatever organization employs they-who-might-seek-prestige would likely own their asses such that they basically couldn't do it.

    At least you gave it a shot and it's better than anything I can come up with. Everything that passes through my mind on the issue is immediately met with a "no not that because of this". Sucks.
     
  12. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    Yah true dat. Theoretically I would think "medical ethics" itself, like the hypocratic oath and stuff should stave this shit, BUT, the people making coporate decisions in this capacity are likely not bound by such things.

    Ah, which makes me think that even though I'd expect them to be dishonest, if you're a medical industry corp. officer, you should have to take the same, perhaps even a more binding oath as the physicians.
     
  13. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    Enjoyed the bit about boners preceding this... but on with points and such...

    I beg to differ, as I find "sinister" and "stupid" to both be quite relative terms, which hopefully you understand. To someone, anyone could be either, etc.

    What you have to understand, at least IMO, is that people, ALL people, will ALWAYS choose what they value, even if they think they're doing something else. So the question is really how to make "the benefit of the whole" valuable to the people who can most affect it, at least as far as I can see it.


    Lol. Perhaps so, but that would just be evolution really eh? I'd say that it's easy to say "evolution should be the motivation" while totally missing the point that evolution really doesn't have a "should" as far as I can tell, it's the result of the struggle to survive, and economics is simply the same thing, except in abstract form, which of course fascinates me and stuff. So if it turns out that they make the pill you suggest, it would seem to me that we should consider the possibility that "apparently from observing the result of evolution, this is what 'should be'". Ya know?

    Meh. Anyway if we want a solution, we have to manipulate motivation to the "greater good", which can generally only be accomplished with some "win-win" kind of setup, where the inventor wins prestige and economic prosperity and the species gains security against whatever was cured.

    The hypocratic oath variation for that industry which I mentioned above might help a bit though, ya think?
     
    Last edited: Sep 26, 2007
  14. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    Did you miss the point where there's no real research motivation towards a cure? Opportunity cost and such? You're right that there are always other things to look at, but common sense in economics says you maximize opportunities where you find them. As such, I would seriously doubt that generally speaking cures will be found because again generally speaking, curing your ass is not a great opportunity. TREATING you is however, a GREAT opportunity.... so research dollars are spent towards treatments, not cures. I'd suspect however, it's said to be for cures because that's more palletable.
     
    Last edited: Sep 26, 2007
  15. Grantywanty Registered Senior Member

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    I have often thought that as a culture we confuse legal with moral too much. Perhaps a well attended by celebrities and Nobel Prize winners event giving out IMMORAL prizes to pharmaceutical companies each year would work. You don't have to change the laws. But Brad Pitt and last year's Nobel Prize winner for Chemistry giving an award to Sandoz for a series of questionable experiments on Ugandan villagers or to ___________ for a hysterically overprised heart medicine or to _________ for covering up the side effects found in one study, etc., might put a little pressure on.

    Shame should be used more often as a non-leglislative tool. (this is not to excuse capitalism and I am quite sure there are better systems to be made, but in the meantime...)
     
  16. Baron Max Registered Senior Member

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    Don't you think such a practice would require a helluva lot of people to keep their mouths shut? It sounds like a helluva conspiracy to keep secret from a press that seems to be able to find out even the most guarded secrets of the land.

    How could "they" keep it all such a closely guarded secret?

    Baron Max
     
  17. spuriousmonkey Banned Banned

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    It's very easy actually. For researchers there is only a reward if they do the research that makes no progress. That is they do research, and on grant applications claim it will help to benefit such and such disease. When you examine the research in question it is clear that it will never lead to a cure for such and such disease.

    However, most funding goes to research for such and such disease. Most researchers are therefore doing such and such disease research. A small fringe does pure research with no practical value. They are marginal. They sometimes shout, but let's be honest, the guy that researches a tunicate by himself at some small university is not as 'believable' as a nobel price winner at a prestigious institute/university.

    The people don't know anything of science (reference: look at sciforums). They will believe anything. A man in an immaculate white coat, looking like a trustworthy doctor, who speaks eloquently, can be trusted much more than some skinny geek who is wearing a t-shirt that states: 'unlike a seasquirt I didn't eat my brain'
     
  18. Baron Max Registered Senior Member

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    So, ...all medical researchers are lying, cheating, unethical pricks? And not one of them would sell that info to the news media?

    The remainder of your post didn't mean jack-shit to me. Care to explain it, or is it just totally unimportant?

    Baron Max
     
  19. Grantywanty Registered Senior Member

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    (my emphasis)
    grant
     
  20. spuriousmonkey Banned Banned

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    It's not a lie perse. It's based on the dogma that all knowledge will eventually help.

    Needless to say, a dogma doesn't equal truth.

    I don't want to explain it again. If it is really important to you I advise you to read it again.
     
  21. Nasor Valued Senior Member

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    I disagree. Nature abhors a literal vacuum because of how gases behave, but there isn't any discernable driving force that causes "nature" to "want" to kill people with disease. The fact that far fewer people are dying from diseases than ever before seems to be proof that humans can use medical technology to "come out ahead" in the human vs. disease game. In the 1920s, bacterial infections were responsible for about half of all human deaths in the west. Now your odds of dying from a bacterial infection are trivially low. Also, as our technology and biological knowledge advances we are able to come out with new drugs/treatments faster and faster. Nature, on the other hand, doesn't really have any mechanism for producing deadly microbes faster. Of course there are things like drug-resistant strains of diseases, but those are cases of the disease trying to "bounce back" after it takes a big hit.
     
  22. wesmorris Nerd Overlord - we(s):1 of N Valued Senior Member

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    No, not at all actually.

    I don't think this is remotely secret, it's just not a topic of interest because it's not like there's "no research". It's just like the research isn't exactly what you'd think it should be I'd guess. But then since you're not a scientist in the field, you wouldn't know. Me either.

    What secret? It's common sense. I'm just saying I don't think a cure for anything would be what is sought for most, if not all research... because it's not good business.
     
    Last edited: Sep 27, 2007
  23. Faerynght Registered Senior Member

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    I wanted to address the OP regarding advances and preventive, treatment, curative, and palliative developments in the last 60 years or so...

    Here is a very short list of the recent advances and developments which were funded in part by the federal government and in collaboration private industry in over 200 diseases.

    Cardiovascular disease and strokes-30 years ago it was common for male/female to die suddenly in this disease population, this population has had a decline in mortality rates by sixty-three (63) percent in heart attack population and seventy (70) percent in stroke population. This is due to research into the cause of the disease, drug coated stints, safe level of blood pressure and cholesterol lowering therapies (both medication and lifestyle changes)

    Cancer-There are more effective targeted therapies, specific molecular targeting to treat tumors with novel agents, detection and treatment (curative and palliative) at earlier stages, exploration of biomarkers, vaccine development to stop recurrence rates, genome studies to understand the biology of cancer and identify treatment targets.

    HIV/AIDS-Development of highly active antiretroviral therapies which have helped with the discovery of cellular mechanism of the disease which has made it more manageable. Development of less toxic agents are in clinical trials at this time. Mother/child transmission has declined by forty (40) percent with drug therapy. Vaccines are in development.

    Pandemic influenza-viral genome and genetic engineering has allowed countermeasures against seasonal and pandemic influenza viruses. Research has developed novel vaccines using molecular biological techniques. Genome sequences from human isolates is now allowing researchers to better understand the viruses and develop countermeasures.

    Diabetes-through research it was discovered that type II diabetes benefited from lifestyle modifications alone rather then agents, in fifty-eight (58) percent of the population resulting in this population being treated with nutrition and exercise. Four (4) million adults diagnosed with diabetes develop retinopathy which has been controlled with the development of novel treatments, without these treatments over four hundred and fifty (450) thousand people would have advanced disease and be blind within five (5) years. End stage renal disease is also prevalent in this disease population without the discovery of early detection, rise in urine proteins,which allows prevention and intervention before requiring dialysis and/or transplant.

    Image guided surgery-new developments in imaging technologies (CAT, MRI and ultrasonography) have led to development of microsurgical techniques. These minimally invasive procedures have led to some pretty groundbreaking discovery in Parkinsons Disease and various other disease groups.

    The changing landscapes of disease marks many successes in preventing, curing, and treating many populations. Due to the advances using various research, lifestyle modifications, new agents, there has been an increase of older patient population which increases the challenge of multiple chronic conditions which require new treatments, cures, and modifications.

    I think it is important to maybe point out some of the advances that have made an impact in medicine over the last few years by medical researchers using federal funding, and private funding.
     

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