Bioethics Discussion Blog: 3 Ethical Questions:in One Day: #1 Right to Meds

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Friday, July 27, 2007

3 Ethical Questions:in One Day: #1 Right to Meds

I am posting 3 medical ethical questions today, all without any preliminary discussion by me but a reference for each so that my visitors, if they desire, can review the issue more completely before responding. However, if you have a strong feeling about the issue, you may go ahead and comment directly. ..Maurice.

Question #1: Should terminally ill cancer victims who have failed to respond to all standard treatments for their condition have the right to be prescribed and administered drugs which are still undergoing pharmaceutical investigation and are not approved by the FDA for use? (Reference: New England Journal of Medicine, July 26, 2007, p. 408.)

5 Comments:

At Tuesday, August 07, 2007 4:24:00 PM, Blogger LisaMarie said...

Yes, definitely.

 
At Tuesday, August 07, 2007 6:33:00 PM, Blogger Maurice Bernstein, M.D. said...

Lisamarie, the answer as described in today's news is "No, not definitely!"

From the Associated Press August 7, 2007:


WASHINGTON - Terminally ill patients do not have a constitutional right to be treated with experimental drugs, even if they likely will be dead before the medicine is approved, a federal appeals court said Tuesday.

The ruling by the U.S. Court of Appeals for the District of Columbia Circuit overturned last year's decision by a smaller panel of the same court, which held that terminally ill patients may not be denied access to potentially lifesaving drugs.

The full court disagreed, saying in an 8-2 ruling that it would not create a constitutional right for patients to assume "any level of risk" without regard to medical testing.


I think it's curious that seemingly everyone has the constitutional right to smoke tobacco and drink alcohol and assume risks that actually have been proven by medical testing. ..Maurice.

 
At Wednesday, August 08, 2007 8:45:00 AM, Blogger LisaMarie said...

I saw the article. I think it's a crying shame that the Abigail Alliance lost. As for alcohol and tobacco, Americans are huge hypocrites when it comes to using substances that can alter human physiology (alcohol is legal but pot is evil, smoke as much as you want but don't try experimental cancer drugs). Maybe it has to do with the strange ways in which people perceive risk. I've heard it said a lot that people are much more accepting of risks that they perceive themselves as being in control of (regardless of whether that perception is correct). E.g., they feel safer driving than flying, though flying is statistically safer. People see themselves as choosing to use alcohol and tobacco, yet somehow think that pharmaceutical companies are exposing them to risky drugs against their will. I have yet to have anyone force feed me prescription medication, so I think that's messed up, but it might explain your observation.

 
At Friday, August 17, 2007 9:43:00 AM, Anonymous susan goold said...

A "right" to access unproven, experimental "treatment"? I think not. Perhaps in some circumstances they may be permitted access...but a constitutional right to a substance that can't even be called treatment (yet) goes way too far.
And--- Who pays for the intervention and any associated services needed? Would those who access it waive any right to sue the manufacturers or researchers if something goes wrong?

 
At Friday, August 17, 2007 2:53:00 PM, Blogger LisaMarie said...

Susan,
Lots of people have criticized the idea of a "constitutional right" to drugs, but I think it's just a pragmatic approach to the way the world is. Basically, think of freedom as being viewed in two different, opposing ways. The first view is that if the Constitution DOESN'T say the government can regulate X, then it's no one's business and you're free to do X. The second view is that UNLESS the Constitution explicitly says that it's your fundamental right to do X, Y, or Z, the government can forbid you to do X, Y, or Z (or force you). In the second framework, in order to be free do to something, whether it's smoke pot, try experimental pharmaceuticals, or use your car as a taxi, you basically have to prove that the constitution says it's your fundamental right to do so. Otherwise, it's taken for granted that the government can regulate that activity as much as it wants. Think of the debate over whether homosexual activity is a right. It prefectly illustrates this issue- either your choice of sexual activity is a fundamental right, or the government can be as far into your bedroom as it wants to be. We live in the second kind of world. In order to establish that you should be free to do something, you pretty much have to prove it's a constitutional right. That's just living in the real world.

 

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