medical ethics: cure vs. treatment given capitalism.

Noted and respected. Not saying that stuff isn't getting a LOT better, and with much more to come. Just saying that "cures" are bad business, which I'd guess any med business man would have to agree with. If not, I'd love to hear why. If the answer didn't involved the bottom line, I'd have to ponder its honesty.

 

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I am not a medical business man so I can not honestly answer, though I am actively involved in medical research at the institutional level. The faculty that I work with is trying to improve traditional treatments while finding new treatment options and potential curative outcomes in the dedicated disease group while complying with biomedical research and social and behavioral research ethics established by the federal government and institution (which are very conservative and stringent especially when dealing with human research subjects). The basic science researchers and clinical researchers are all actively involved in developing novel approaches to the disease. Unfortunately we have been unable to determine the cause of the mutation in cell programming. There have been outstanding advances in experimental agents, agent delivery methods, surgical equipment and procedure, and vaccine developments which is specifically being designed to prevent disease recurrence after curative surgery and chemotherapy. I work closely with industry sponsored studies both human, animal, and in vitro as well as federal grant sponsored programs.

I have much more respect for the pharmaceutical industry since working in this environment, you do not have to take the medications offered to you or even follow your Drs. advice. It is your choice.

We are trained to be responsible for knowing and upholding the ethical principles of The Belmont Report. The clinical investigator is the ultimate protector of the participant's rights and safety. The researcher should have the resources required to conduct research in a way that will protect the rights and welfare of participants. The researcher should also consider proximity or availability of other resources such as the proximity of an emergency facility for care of participant injury, or availability of psychological support after participation. Researchers should stop a research study if resources become unavailable.

Here is a link to the Belmont Report:http://ohsr.od.nih.gov/guidelines/belmont.html

I am unsure if anyone is involved clinical care or human subject research so I thought that The Belmont Report might give people not actively involved some insight on the some of the most basic ethics involved in medical research.

There are so many variables of health care from patient care to research.

 

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Well thank you for that Faerynght. Gives me a little hope that I'm wrong. I wonder if the scope of the bellmont report would include the business end of research, or if so - it makes any difference. I should have tempered my OP with recognition that cures aren't easy to find either. Regardless, I still have a hard time getting past the basic premise that cures are bad business... but hopefully my difficulty getting past that idea doesn't reflect the reality of medical research.

 

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Here is a journal that I often read, Journal of Medical Ethics.


http://jme.bmj.com/

Access is free and reflects medical ethics on all levels from research to care. I think you may be able to find some answers to some of your questions in past issues. Like any profession you have varying levels of competency and ethics.

 

The problems with the pharmaceutical companies for me come in post research often. Their undue influence on policy makers and doctors and the business of creating markets via advertising, influencing the media including the internet, via doctors and hospitals and other PR mechanisms. The current fads around the drugging of children and pathologizing individual children without looking at, as a couple of possible alternative, societal factors and nutrition. Some of the work of pharmaceutical companies has been essentially disinformation campaigns. Adults may be free to choose, but this does not let the pharmaceutical companies off the hook if their intent is to manipulate - parallels with the tobacco companies' behavior is appropriate. Children are often not free to choose and not at a stage when they can stand up for themselves and decide. The profit motive is causing P companies to look at children, for example, much as toy manufacturers do: how can we increase our market share?

I think we will lóok back on this period of history with a great deal of sorrow actually.

 

Hello, Wes,

Like many threads that have grown longer than a single page, this one contains some good information and some highly-biased, and usually wrong, opinions.

Let's try to establish a little perspective here, shall we?

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First of all, an effective treatment can (and usually does) cost millions of dollars, require years of research, development, tests and trials. In other words, it's quite difficult to accomplish. And a true cure takes several orders of magnitude beyond that!

Certainly, selling treatment drugs are good for the bottom line - but not nearly as good as an actual cure would be. Not only that, it would take years for the cure to be dispersed all over the world - AND even a cure does not eradicate a disease. It can resurface at any time and therefore create a steady market which is ALSO good for the bottom line. For example, cholera can be cured but it regularly breaks out in places hit by floods and other natural disasters. And the same goes for many others for which a cure exists.

And as has already been pointed out, there's always something new showing up that needs a cure. Along those same lines, a recent news article stated that scientists have discovered over 100 distinct and different forms of virus that cause the common cold. So is it any wonder we don't have a cure for it yet?

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It should also be remembered that all drug companies continue to make more than just a decent profit from pain medication. And I'm not talking about the simple frequent headache or stubbed toe but rather the pain that follows oral and other forms of surgery. There's also a very large percentage of the population that suffers from true chronic pain like back problems and arthritis. Ordinary NSAIDs (OTC) do little to nothing for those folks.

Just imagine the HUGE windfall that any drug company would reap if they found a cure for AIDS or the common cold! There would still be plenty of infectious outbreaks to follow for decades and longer. It most certainly would not be just a one-shot boom then bust.

Does that help a little?

 

I hope this helps Read-Only, below is an article that explains how drug costs. With a little research one can find instances of drug companies including costs of production and marketing in their development cost estimates. This is a must ready!
http://findarticles.com/p/articles/mi_m0815/is_2001_August/ai_76937421

 

I hope this helps a little more:

http://www.citizen.org/pressroom/release.cfm?ID=954

 

Notice also that pharmaceutical companies dont like stem cell research because stem cells cure the disease. Read-only, companies make a lot more if they can charge 75k annually for the balance of a persons like than if they can charge 150k once to cure a disease....real simple math. Funny how Bush II has severely limited stem cell research...wonder why. Isn't Bush II the guy who signed into law the medicare prescription drug deal that obligates the government to help the elderly purchase drugs and forbids the government from barganing with the drug companies for a better price.

 

Well, I just don't think that all of those people could keep such a consiracy secret from so many for so long from so many prying eyes.

Baron Max

 

Both of those were interesting, Joe, thank you. But we're not discussing the honesty/integrity of the drug companies. The topic here is treatment vs. cure.

 

You're still missing the main point. Curing isn't the same thing as eradicating. Not by a long shot. For example, we've been able to cure pneumonia (if caught in time) for DECADES but there are still thousands of new cases of infection every year.

I believe you (and others here) are operating under the mistaken assumption that being able to cure a disease is the same thing as wiping it off the face of the Earth. That's not even close to reality.

 

The tobacco industry managed to keep it a secret for a long, long time that THEY knew smoking was bad for you. Not that smoking was bad for you, but that THEY knew this themselves. (I know you don't believe smoking is bad for you, Baron, but the point is even the tobacco industry did, for a long time, and internal memos showed that their own researchers believed this. Memos that were suppressed. In the public eye they maintained that they did not believe it was dangerous, including perjurous statements to congress.)

 

Currently, only about 20% of the drugs on the market are well studied in children. Nearly three-quarters of all drugs prescribed to children are not approved for pediatric use by the FDA. There is inadequate information regarding the safety and effectiveness of drugs for children. It has not until recently been a legal or regulatory requirement to test medicines for children. Infants and children are frequently exposed to medications without the benefit of adequate studies to determine their safety, effectiveness and established dosages appropriate for their age. This lack of age-specific labeling for drugs may result in compromised treatment or even harm.

As a parent I have often questioned and evaluated the information provided to me by my childs PCP regarding any prescriptions and vaccines she is given. I would not give her any medication, OTC or prescribed, without fully investigating the risks and benefits if it is applicable and the information were available which it often is not due to lack of research and development in infants and children.

 

The Surgeon General released the risk of cancer and heart disease back in 1957, are you referring to conclusive research by tobacco companies and physicians prior to that release of information or after? Anyone that started smoking after 1957 should not claim ignorance in regards to the associated risks in smoking.

 

I THINK THIS LINK SAYS IT ALL!
http://www.cbsnews.com/stories/2007/03/29/60minutes/main2625305.shtml

 

your forgeting universities, resurch hospitals and places like CSIRO who are publically funded. For starters the goverment wants to pay less for health care (im assuming that so do the private funds in the US) so they pay for the resurch and then they sell the paitent. If the company doesnt use the paitant well, there are people who know its there and pressure is brought to bare on the companies involved.

 

I haven't been able to confirm or disprove this yet (I would like to, so a reliable link would be appreciated), but my brother's family doctor told him something intereting the other day.

My brother just found out that his son is allergic to fish.
He brought him to the doctor to inquire about allergy shots like my brother had when he was younger.
My brother would go in for regular allergy shots, which were small doses of what he was allergic to, in order to build up a tolerance or immunity to the allergen.
His doctor told him that pharmaceutical companies no longer produce these allergy shots because it is more advantageous for them to continue selling antihistamines than to cure people of their allergies and lose a repeat customer.

 

Seeing through the smoke screen.

What you are missing is that the tobacco companies disputed the Surgeon General's conclusions. For various periods of time over the next thirty years the tobacco companies either denied that smoking and tobacco caused or contributed emphysema, heart disease, low birth weight, lung, breast, nasal, esophageal, mouth, and stomach cancer, or argued that the claim was unproven. They also denied that nicotine was addictive or that they manipulated the nicotine content of their products.

But there is more.

What came out during the class action lawsuits in the 1990s was that being concerned about these issues the tobacco companies had conducted their own research on health effects and verified the results. After verifying those
results then continued the advertising campaign disputing them.

Some of the tobacco company executives, after being told by their own scientists that nicotine was addictive, testified before Congress that it was not.

 

one_raven possably in the US but they are definitly still avalable here, because health care is mostly goverment run here there is a twin focus on long term treatments for a) the improved quality of life of the pt and b) it costs the goverment less if they prevent or cure something in the inital stages than to keep paying for it for ever

thats where you get the focus on Primary Health (not to be confused with primary health CARE which is a compleatly different thing

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) and public health