Too Much Good can be Bad?:The Issue of Narcotic Prescribing

Ethics is all about sorting out the "good" and the "bad" in various scenarios and perhaps initiating an act which can be supported as meeting an ethical "good". But is there such a thing as too much "good"  and if so could that be considered as "bad"?

The stage, radio and music celebrity of years ago, Mae West said "too much of a good thing can be wonderful."  But is that really true? And, since Ms. West was known for her "double entendres", if it is described as "too much" doesn't that imply that maybe it isn't so wonderful, if wonderful implies something good and still wanted.  Can one repeatedly accept something as considered a "good" actually become a "bad" or if not "bad" then perhaps less good for that individual?

There is current  concern by some in the medical profession regarding the excessive prescription and persistent use of narcotic pain medications for chronic pain which we might see as representing an example of a "good" which appear contrary to Ms. West's declaration. Yes, these medications represent a "good" for those suffering chronic pains.  The  "good" represents the significant reduction of discomfort and suffering provided by these medicines.   But those concerns as expressed in the Editorial of the October 2 2013issue of the Journal of the American Medical Association are that these medications are being over-prescribed and as the pain is eased, not being adequately tapered down or the prescriptions finally  discontinued.  The issue of addiction to prescribed narcotic pain killer medication  by U.S. military veterans poses a similar issue of "good" vs "bad" and is detailed in a presentation October 3 2013 on PBS Newshour.  Rather than provide the veterans necessary personalized non-narcotic therapy it is suggested that doctor-patient time limitations lead simply to the prescription of repeated narcotic refills. And that may lead to addiction as well as unforeseen consequences.  So what was originally  a "good thing" to relieve the veteran's initial pain and suffering has now become supporting a deadly habit. 

One can conclude that Mae West's "too much of a good thing can be wonderful" if not taken as a double entendre, then that statement can certainly apply to the following:  proper, timely, personal attention to all the patient's medical needs understanding the documented consequences of all therapy.  But all this repetition of that "good thing" requires more than some casual approaches to insure that the cumulative results will indeed be "wonderful". ..Maurice.

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