Monday, December 19, 2011

Dreams my father never had

Thirty years ago my father entered a hospital for the last time. His heart and lungs were weak from forty years of nicotine exposure. My dad could never conceive that his physicians would ever hasten his demise with treatment plans that were not in his best interests. Three decades later his worst nightmare has become a reality. Cutting edge and aggressive therapies are being constrained by an overreaching government that has burdened physicians with trepidation not encouragement. Death panels are not necessary, a physician’s fear of malpractice suits and or medical license revocation is sufficient to impede overzealous therapies. Advanced cardiac disease or stage four cancers do not always lend themselves to well categorized therapeutic interventions. Therapies on the edge many times become  tomorrow’s cures. Physicians are being coerced into following a train of thought that reflects a one pattern fits all mentality. Elements of medical care by their very nature cannot be contained by a singular standard or line of reasoning. In the instance when a person is confronted with a life threatening issue many standard treatments do not match the infirmity incurred. Should a physician move beyond the realm of common thinking and take medical care to the edge or utilize government rational to limit application of therapies? Present mindset is to deter those who think outside the proverbial box and go to the limits to save a life. Presented with a life threatening cancers in the 1970s, physicians would follow through on any therapy to find a cure. In 2011 physicians under the same or similar circumstance would tell a patient go enjoy your remaining days. A recent occurrence in my own family exemplifies the course physicians will take when they confront a stage 4 pulmonary cancer. Instead of attempting to arrest the tumors standard palliation was offered. Why go to the edge when a potential sanction a year down the road is a real possibility. Medical care does not come in a can or a box. It cannot be distilled down to a few basic essentials. Diagnostics and therapeutics are complex offerings which become more intricate as a disease moves through its various stages. Physicians need support and guidance not confrontation and sanction when pursing various life saving measures. Tell that to the Maryland Board of Physicians who are reactive not proactive. As a result of administrative negligence, failure to promulgate rules and suppression of physicians’ basic due process rights, Maryland’s physician board will cause many needless deaths. The irony is those who force physicians to follow fabricated standards of care may one day beg a doctor to go to the edge for them. Mark Davis, MD author of Demons of Democracy,

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