The other day in toxicology the professor recounted a trivial anecdote (or should I say antidote, considering the circumstances?) which seems to encapsulate a central dilemma in health care. 3 guys drive up to the ED and drop one of their buddies out at the door before speeding off. The guy was whacked out on heroin, emaciated, and incoherent. The ED doc pushes some naloxone (Narcan™) which is a reversal agent for opiates. It acts by competing for the same receptors as the opioid, and winning the competition. Since the heroin can't bind the receptor, no response is iniated and the addict's high is prematurely terminated. It also suppresses other effects of opioids aside from the high, depressed respiration for instance. The guy gets better and leaves, presumably to go shoot up and continue to ruin his life.
The episode raises several ethical questions which delineate some of the problems with US healthcare. What good did the doctor's intervention do? Yes, he saved the guy's life, but to what end? Should the doctor be legally required to help the guy? Should he have treated the guy in the first place, given that by treating him, he would likely be perpetuating a pattern of illegal behavior?
*editor's note: I deleted the rest of this post because it didn't say what I wanted it to.
1 comment:
I thought the last part of the post raised some very good questions. So what did you want it to say?
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