Slide 1: The “what do you have to lose?” approach – a common plea of families desperate for treatment, must be balanced by the fundamental dictum of the Hippocratic Oath: first, do no harm.
Slide 2: Causing harm in an effort to do something is not without precedent.Let’s look at the last coronavirus outbreak – SARS-COV in 2003.
Slide 3: THE TAKEAWAY: The desire for the certainty of treatment during an otherwise uncertain time can lead to flawed studies without sound design.
Establishing practice patterns today without proper study might have long term ramifications – physical, social, and economic.
Slide 4: “When we doctors flip-flop on our advice to patients, it usually is not because the treatments stopped working…it is usually because the practice never worked – we were wrong all along. We promoted it before we had properly studied it.” VINAY PRASAD & ADAM CIFU, ENDING MEDICAL REVERSAL
Slide 5: At a time when the call to act benevolently is so strong, it is acceptable to answer with human compassion. As physicians, we have a dual responsibility: to match our desire to help with healthy skepticism of emerging treatments to ensure we first do no harm.
- Zagury-Orly I and Schwartzstein RM. Covid-19 – A Reminder to Reason. NEJM 2020 Apr 28. doi: 10.1056/NEJMp2009405. PMID 32343505.
- Stockman LJ, Bellamy R, Garner P. PLoS Med 2006 Sep;3(9):e343. PMID 16968120.
- Prasad, V nd Cifu, A. Ending Medical Reversal. Johns Hopkins University Press (2015).
Tags: beneficence, bioethics, COVID, COVID-19, do no harm, ethics, food for thought, hemolytic anemia, hippocatic oath, malevolence, pandemic, ribavirin, SARS