Author Topic: Participate in this Ethical discussion.  (Read 12583 times)

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Offline Admin

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Participate in this Ethical discussion.
« on: November 13, 2010, 06:29:37 PM »
Placebo is a dummy medicine containing no active ingredients; an inert treatment; Anything of no real benefit which nevertheless makes people feel better & it works because of the patient's belief in it, not because of the actual physical change it produces.

Please justify your answer?


"you never cure a patient, you treat pain often but you always comfort the patient."
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Offline Sjama

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Re: Participate in this Ethical discussion.
« Reply #1 on: November 14, 2010, 02:51:49 AM »
i do believe that i cant lie to someone who is despaired for help and from that point i would not give placebo just to please that patient.

Offline Dr.Adnan

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Re: Participate in this Ethical discussion.
« Reply #2 on: November 14, 2010, 01:09:05 PM »
There has been many medical studies reporting the efficacy of placebo in treating many chronic conditions. your judgment to give placebo  depends on the situation, e.g in Rural Somalia you may see elderly patient who claims that injection is their only treatment, you try to convince them but "You know How somalis think" , Madax-adayg kicks in and they refuse, the solution is one single shot of saline and you may not see that patient for a year or a two, plus you don't that patient to  suffer in his hallucinations for a long time.

The thing we should be concerned about is Addiction to Placebo, which is one of its new side-effects . Psychiatric consult is recommended, if not available try to address the patient and his family directly about the problem.

One other problem is breaching the patients autonomy and trust in the account of beneficence, so this conflict between Autonomy and beneficence is to be handled carefully for it might effect future doctor-patient relationship and bring mistrust between them.

After all, Doctors should be smart to know when placebo is of advantage to the patient and when it is harmful ......... ;D
**Ruuxaan Dantiisiyo aqoon, waxa daryeelaaya**
**Inuu Deeqda Eebahay ka qaday, dib u xusuusnaada**
Hadraawi...

Offline Diagnostic

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Re: Participate in this Ethical discussion.
« Reply #3 on: November 15, 2010, 04:57:33 PM »
Quote
Using placebos therapeutically requires extraordinary caution:

First, how placebos affect the mind remains to be elucidated.
Second, therapeutic placebo use entails deceit, which can seriously impair the doctor-patient relationship (which alone can have a strong placebo effect).
Third, the physician may misconstrue a salutary pla-cebo effect as evidence that the patient's illness is wholly or largely a neurosis.
Fourth, there is no legitimate program for health professionals that focuses on how and when to use placebos and on how to judge their effects.
Fifth, there are no standards for managing possible aftereffects of placebo administration—i.e., for dealing with any consequences of learning that a health problem and/or relief from it was "all in one's head." But the dearth of information on the placebo effect and the need for caution do not negate the legitimate findings of clinical researchers and should not rule out—or automatically render unethical—all therapeutic placebo uses by clinicians.
by Kenneth E. Legins

We are discussing here whether it is ethical prescribing harmless placebo but did we think about prescribing harmful unnecessary medications for a patient just to increase our income as experienced in some our doctors back home.

I have seen with my own eyes several patients holding a bag full of different medications which to my surprise some of them interact with each other.

Another common problem is ordering unnecessary expensive and sometimes invasive investigations e.g X-rays for the same reason mentioned above & when you ask why this doctor ordered "Liver or Renal Function Test" for a patient complaining of common cold or simple pneumonia, the answer will be: to lessen the patient's anxiety or unacceptable justification for "ruling out" other causing diseases!!!

To them, I say: please use your clinical reasoning and critical thinking to minimize your large differential diagnosis list before ordering such expensive tests.

Such behavior of prescribing dozens of medications and doing ultrasound for every patient complaining of abdominal pain created false belief among the community that a good doctor is always who gives bunch of drugs and scans the patients with his machine!!!!!!!......

By lessening the patient's anxiety or avoiding him the side effects of unnecessary drugs justifies the placebo prescription.
In diagnosis think of the easy first.
Martin H. Fischer

Offline Admin

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Re: Participate in this Ethical discussion.
« Reply #4 on: December 23, 2010, 05:23:11 PM »
Researchers at Harvard Medical School have found that placebos work even when administered without the seemingly requisite deception.

The study published yesterday in PLoS ONE
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0015591
"you never cure a patient, you treat pain often but you always comfort the patient."
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Offline Pharmacist

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Re: Participate in this Ethical discussion.
« Reply #5 on: January 08, 2011, 05:39:55 PM »
Can pharmacist told such patient that his prescription is placebo?!
Really those questions are ethically tricky!
Pharmacist is highly-trained and skilled healthcare professional who perform various roles to ensure optimal health outcomes for his patients.

Offline Diagnostic

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Re: Participate in this Ethical discussion.
« Reply #6 on: March 12, 2011, 07:07:11 PM »
I believe pharmacists should tell only if the patient wants to check whether the dug contains active ingredients or not.
But it's not ethical to tell the patient that his doctor gave him a fake medicine knowing that the doctor prescribed this medication for a reason.

What do you think?
In diagnosis think of the easy first.
Martin H. Fischer

Offline Abdulrazzak

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Re: Participate in this Ethical discussion.
« Reply #7 on: March 13, 2011, 05:46:29 PM »
@Diagnostic   you posted  a relavant info but whithout complete info  you may better have knowlge of forensic and law of drugs .. how when Doctors can give a Fake or undiagnosted disease can give ?
Make sure where are here for gaining  knowledge  ... aprrove it as scientifically ?

Offline Diagnostic

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Re: Participate in this Ethical discussion.
« Reply #8 on: March 14, 2011, 12:09:51 AM »
@Diagnostic   you posted  a relavant info but whithout complete info  you may better have knowlge of forensic and law of drugs .. how when Doctors can give a Fake or undiagnosted disease can give ?
Make sure where are here for gaining  knowledge  ... aprrove it as scientifically ?


Fake pills, Fake drugs & Fake medicine are just another names for placebos.
Placebos can be used in many ways & it's very important is certain fields like the medical researchs & placebo controlled studies.
Placebos are also called sugar pills used to treat for terminal ill patients, for pain, for depression, for asthma, allergies, chronic fatigue syndromes and also sometimes give operation-ike outcomes for surgical patients.
http://www.chiro.org/research/DISCONTINUED/The_Placebo_Prescription.shtml
Placebos is sometimes endorsed as necessary deceptions due to it's positive impact on the patient's condition.
In diagnosis think of the easy first.
Martin H. Fischer

Offline Abdulrazzak

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Re: Participate in this Ethical discussion.
« Reply #9 on: March 14, 2011, 03:27:58 PM »
Placebos is sometimes endorsed as necessary deceptions  but I was talking about Doctors  in somalia they dont have a such  spectrum  knowledge making research ..
Thankz for a sharing

Offline Diagnostic

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Re: Participate in this Ethical discussion.
« Reply #10 on: March 16, 2011, 10:47:27 PM »
I agree with you but we were debating about placebos in general.

Using placebos can be common in anywhere and making research is not a condition but can be prescribed for people who visit doctors just to get medication thinking that may help her or his chronic pain but the patient may get addicted to the drug or may end up with bad side effect as a complication of overusing the prescribed medication.

In such condition patient can be given a dummy pill which of-course will help him by relieving the pain though placebo effect.

What do you think about this?
In diagnosis think of the easy first.
Martin H. Fischer

Offline Pharmacist

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Re: Participate in this Ethical discussion.
« Reply #11 on: March 18, 2011, 08:20:00 PM »
I agree if that's the reason for prescribing but such thing is not happening in Somalia since doctors prescribe unnecessary medications for undiagnosed diseases.

The strange thing I noticed is that even the doctors were affected by the laymen that they use the same non-medical terms when referring to the condition of the patient or prescribing drugs.

Example: Naqas ayaa hayo ee ku dhufo cirbadda naqaska?!!!
Mr Diagnostic, is there something like this (Cirbad Naqas or Cirbad Dhiig-joojin?)
Pharmacist is highly-trained and skilled healthcare professional who perform various roles to ensure optimal health outcomes for his patients.

Offline Diagnostic

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Re: Participate in this Ethical discussion.
« Reply #12 on: March 28, 2011, 07:56:48 PM »
These terms are used by some by non-professional health workers in Somalia.
For example, they called dexamethason injections as "Cirbad Naqas" which is not right.
Also they call "Vit K injection" as Cirbad Dhiig Joojin" which is also wrong.

These wrong misleading terms led to wrong beliefs that there are certain injections that can be used to do magic things like awakening from coma, stopping bleeding, disappearing the jaundice from the body etc.
In diagnosis think of the easy first.
Martin H. Fischer

Offline Abdulrazzak

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Re: Participate in this Ethical discussion.
« Reply #13 on: March 29, 2011, 11:48:54 PM »
Actualy  during my studing and experience somali health is different what we tough so let us help in terms of needs in somalia you talking placebo there is ORS  industry in somalia so we need to think how can we help. Sharing your ideas was good but not uptodate 2 somalia. Thankz

Offline Pharmacist

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Re: Participate in this Ethical discussion.
« Reply #14 on: March 30, 2011, 08:48:49 PM »
Actualy  during my studing and experience somali health is different what we tough so let us help in terms of needs in somalia you talking placebo there is ORS  industry in somalia so we need to think how can we help. Sharing your ideas was good but not uptodate 2 somalia. Thankz

Is this Oral Rehydration Solution (ORS) & Where?
Pharmacist is highly-trained and skilled healthcare professional who perform various roles to ensure optimal health outcomes for his patients.


 

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