tag:blogger.com,1999:blog-5393996338560944889.post6511891958339966730..comments2024-03-02T02:26:00.928-05:00Comments on bleakonomy: I seem to recall a certain oathtetracontadigonhttp://www.blogger.com/profile/04604381739383227553noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-5393996338560944889.post-54262520215293329392011-01-06T11:47:04.524-05:002011-01-06T11:47:04.524-05:00Ah, cosmetic surgery. There are certain circumsta...Ah, cosmetic surgery. There are certain circumstances wherein the medical need is clear, such as women who have significant back problems due to breast size, and thus seek breast reduction. Ditto women who are status-post mastectomy. I have also seen patients who have a notably unusual feature that makes them extremely self-conscious, and are genuinely suffering psychologically. In all of these cases, I think the ethical argument is clear.<br /><br />Now, as far as the "amount" of plastic surgery that is performed in this country and the means by which the performing surgeons get themselves to sleep at night go, I don't have a nickel in that dime. The profession may sanction it, but I personally can't. There's no justifying Heidi Montag, for example. I don't have any opinion about her right to "enhance" (or, perhaps more accurately, disfigure) herself, which I think should be as free as anyone's to snort their brains into oblivion. But I will concede that there is a similar "do no harm" conundrum at play.<br /><br />I am sure, given the chance to do so, many members of my esteemed profession would avail themselves of the opportunity to make scads of money selling dope to dunces. Call it what they will, however, it will never be <i> medicine. </i>Danhttps://www.blogger.com/profile/11213051268392108382noreply@blogger.comtag:blogger.com,1999:blog-5393996338560944889.post-36892676938434448212011-01-06T09:51:20.821-05:002011-01-06T09:51:20.821-05:00What is the therapeutic benefit to modifying a per...What is the therapeutic benefit to modifying a perfectly normal, functioning nose via cosmetic surgery, or adding 2 cup sizes to a set of breasts, other than catering to human desire? If the medical profession can justify the amount of cosmetic surgery performed today, I have no doubt it will find a way to rationalize the ethics of dispensing meth (maybe under the guise of weight loss).<br /><br />I say this as a reader who has tremendous resepct for your professional ethics, and I in no way disagree with your take on the whole recreational drugs via prescription issue. But as resident gadfly I would be remiss not to point out the camel already comfortably ensconced in the tent, beckoning to the herd outside.Gadfly Johnnoreply@blogger.comtag:blogger.com,1999:blog-5393996338560944889.post-40627705812625534772011-01-06T08:50:54.455-05:002011-01-06T08:50:54.455-05:00Providing drugs to junkies (which I read as synony...Providing drugs to junkies (which I read as synonymous with "addicts") is one thing. I can see physicians being willing to dispense controlled substances in those circumstances, though I myself am not one of them.<br /><br />But that still doesn't answer the question of how to deal with people who want to use dangerous, addictive substances on a recreational basis. There is no therapeutic benefit to be gained from providing an ostensibly healthy patient with methamphetamine. It runs counter to the obligations and ethics of medicine.<br /><br />One can mount an argument that an unwanted pregnancy is a medical condition, and that women seeking it are taking care of their own bodies. (I think that argument begs the question, and am not necessarily endorsing that viewpoint simply by mentioning it.) "I want to get high" is not a medical condition, no matter how you slice it.Danhttps://www.blogger.com/profile/11213051268392108382noreply@blogger.comtag:blogger.com,1999:blog-5393996338560944889.post-59291358746654519542011-01-05T09:36:05.075-05:002011-01-05T09:36:05.075-05:00The whole should physicians be required to provide...The whole should physicians be required to provide abortion services issue wasn't an automatic yes, but IIRC there were arguments by reasonable people that yes, physicians ought to be required to offer "socially sanctioned" services. Pharmacists, too. I would expect a similar discussion about professional obligations if the War on Drugs takes this path.<br /><br />IIRC (I'm a bit under the weather this am) the Netherlands manages the whole provide drugs to junkies thing. Surely the damage if the US tries it will be less than the damage our current choices is causing.Gadfly Johnnoreply@blogger.com