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Unreported Side Effects of Powerful Drugs (part 3)

Posted Aug 11 2008 9:07pm

A comment on the previous post in this series — thanks, Vesna! — led me to a horrifying story about what happened to someone whose doctor prescribed statins (an expensive and nearly worthless class of drugs) because his cholesterol numbers were bad. (My friend and collaborator Norman Temple has written about the true value of statins.) The doctor did not warn him of the dangers, which were great. When his troubles began, he should have simply stopped the drug. What actually happened was that his doctor prescribed another dangerous drug. And his troubles got worse. Shades of Jane Brody!

I know a similar story. The elderly mother of a friend of mine was taken to the emergency room of a hospital because she had some sort of attack. It was the third such attack in a year. Her children were concerned. She was not of sound mind. Heroic measures to help her? Or a peaceful death? They chose a peaceful death. She was moved to a hospice. By mistake, her six prescriptions failed to be transferred. A clerical error. So she wasn’t able to take her usual drugs. She soon got better! Within a week or two she returned home. The drugs her doctor had prescribed had been killing her. Nobody had noticed.

First do no harm is a scary motto because it shows that those who take it seriously — supposedly the entire medical profession — aren’t thinking clearly, as I’ve heard Robin Hanson point out. It’s like English teachers having a motto with a word spelled wrong. And the consequences of doctors not thinking clearly — not doing something as obvious as stopping dangerous drugs when the patient gets worse — can be terrible. My suggested replacement motto: Learn something from everyone who comes to you for help.

This is closely related to self-experimentation, of course, which is all about figuring out for oneself what effect something has. I got a lot more interested in self-experimentation when it showed me that an acne drug I’d been prescribed was worthless.

Part 1.

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