routinely prescribe placebos to their patients.
The article discusses the ethical problems with this practice, but
fails to challenge an argument concerning the treatment of
"controversial" diseases like fibromyalgia:
"Dr. William Schreiber, an internist in Louisville, Ky., at first
said in an interview that he did not believe the survey's results,
because, he said, few doctors he knows routinely prescribe placebos.
"But when asked how he treated fibromyalgia or other conditions that
many doctors suspect are largely psychosomatic, Dr. Schreiber changed
his mind. 'The problem is that most of those people are very
difficult patients, and it's a whole lot easier to give them
something like a big dose of Aleve,' he said."
I have written a letter to the editor pointing out that:
* Fibromyalgia is classified as a real disease in the International
Classification of Diseases
* The "placebos" being prescribed are real medications that might
cause harmful side effects
* Patients have the right to know if their doctors believe they're
not actually sick. With that knowledge they can make informed
decisions about whether to stay with those doctors (and continue to
pay them), or to seek out someone else.
It seems likely that the New York Times will receive hundreds of
letters regarding the ethics of prescribing placebos in general. It's
my hope that if enough of us write in specifically about how doctors
treat "difficult" patients with "controversial" illnesses, they'll
print at least one.
To submit a letter, you can e-mail firstname.lastname@example.org , fax to (212)
556-3622, or mail to:
Letters to the Editor
The New York Times
620 Eighth Avenue
New York, NY 10018.
Letters should be no longer than 150 words, and they will only
publish letters that refer to an article that appeared within the
last seven days. "Half of Doctors Routinely Prescribe Placebos" went
to print on October 23.
If you have a blog, you might also want to direct your readers to the
article. People with ME, fibromyalgia, and other invisible illnesses
should be aware that doctors may not tell patients when they don't
take their diseases seriously. I've posted my response here: http://tinyurl.com/plac-ate-ebo
* * *
So, it's not only that I paid the bill for those doctor appointments where I should've been looking to find a doctor who took me and my condition seriously, but that I will pay the price for the rest of my life for the doctor not being honest with me that he had no intention of EVER giving me the correct medication for what's really wrong with me.
He was presented with an existing specialist diagnosis -- one he chose to discredit because he didn't believe the condition was real -- so this was not a case of misdiagnosis but of intentionally deceiving me as to his beliefs and intentions, and depriving me of the opportunity not only to change doctors but to ever return to the career I loved. And to this day, he doesn't see that he did anything wrong.
It happens often enough that there's a word for it: iatrogenic.