By Ira Sharkansky
JERUSALEM–Do no harm is a standard traditionally taught to medical students that modern physicians must violate. It will be violated as well by whatever health measure comes out of the Congress and White House.
JERUSALEM–Do no harm is a standard traditionally taught to medical students that modern physicians must violate. It will be violated as well by whatever health measure comes out of the Congress and White House.I know of no modern medication that is free from harm, or side effects. Some are serious, and may cause death if not monitored. And they may do harm even if monitored.
Some individuals will be harmed by any reform coming out of Washington. A number will find their costs increasing, some may find their medical paperwork made even more cumbersome, and many will experience pain to their sentiments about what is right or tolerable.
Don’t make things worse is a more valuable standard. It recognizes that some harm will be done, but aspires to actions that do more good than harm. Medications that pass the scrutiny of sophisticated governments are likely to do more good than harm. From what we know of the proposals on the tables in Washington, it is likely that they, too, will do more good than harm.
Probability is essence of good medicine and good politics. Nothing is certain. Even medications thought to be worthy may do harm. Remember thalidomide. I spent several months handicapped due to a widely prescribed generic medication. After more than a year of success with the drug, I found myself in the small percentage of users with muscle damage.
Nothing is perfect, in medicine or politics. What is the likely cost (in money and other measures)? Who will probably gain and who will lose, and by how much? are the questions to be asked.
Be a good citizen. And be your own physician. These are useful slogans, assuming that one avoids the extremism of micro management. Certainty is the antithesis of probability.
Look at the pamphlets that come with medication. They include so many warnings as to be worthless, except to provide the manufacturer an opportunity to say, “We warned you.” The internet provides a great deal of useful information, but also material that is nothing more than hyped up claims by providers or activists.
So what to do?
There are no easy answers. Be alert. Expose yourself to different sources of advice (second opinions), but do not think you can be certain.
It ain’t easy, but we are living longer, with opportunities to make our lives better. More Americans will, in all probability, live better as a result of the patches that President Obama and his allies add to the patches in medical delivery created over the last 60 years. The country with the best medicine in the world, but the worse medical delivery of well-to-do countries may move up a bit in the standings.
It isn’t done until it is done. The ideologues who do not want any changes in the way Americans get their health care may escape the process without harm.
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Sharkansky is professor emeritus of political science at Hebrew University