"Tutkimuksen mukaan noin puolet amerikkalaisista lääkäreistä kirjoittaa potilailleen säännöllisesti placebo-lääkkeitä tai vitamiineja joilla ei ole todettu olevan apua potilaan terveydentilaan. Monet lääkäreistä eivät ole rehellisiä potilailleen siitä mitä he tekevät. Lääkäreiden käyttäytyminen on ristiriidassa Amerikan lääketiteellisen yhdistyksen ohjeiden kanssa. Niiden mukaan lääkäreiden tulee kertoa potilailleen tarkasti käytetyistä hoitomenetelmistä." Koko artikkeli löytyy allaolevasta linkistä.
Ps. Suomessa potilaiden oikeudet tiedonsaantiin ja päätöksentekoon on säädetty lailla. Se ei kuitenkaan tarkoita tiedonsaannin toteutumista käytännön hoitotilanteissa.
LONDON (AP) - About half of American doctors in a new survey say they regularly give patients placebo treatments - usually drugs or vitamins that won't really help their condition. And many of these doctors are not honest with their patients about what they are doing, the survey found.
That contradicts advice from the American Medical Association, which recommends doctors use treatments with the full knowledge of their patients.
"It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and one of the study authors. "There is an element of deception here which is contrary to the principle of informed consent."
For the full article click on the link
http://apnews.myway.com/article/20081023/D940G7Q01.html
USKOMUSHOITOA
Valvojat: Jatta1001, Borrelioosiyhdistys, Bb
Paljonko maksat minulle siitä että laadin hoitosuositukset? Tohtorit Sniderman ja Furberg kirjoittavat aiheesta arvostetussa JAMA-lehdessä. Esim. tri Furberg oli kuuleman mukaan saanut tappouhkauksia kertoessaan julkisuudessa Vioxxin terveysvaaroista.
"Ennen kuin otat lääkettä - sinun kannattaa tutustua huolellisesti valmisteeseen ja seuraavan artikkelin mukaan myös heidän sivuillaan olevaan tietoon lääkkeistä ja miten niiden käyttöön liittyviä hoitosuosituksia tehdään. Hoitosuositusten laatimisessa painotetaan niiden pohjautuvan puhtaasti tieteellisiin tosiasioihin eikä mielipiteisiin, mutta .. Useimmat lääkärit kuvittelevat virheellisesti, että hoitosuositukset on laatinut objektiivinen paneeli jolla ei ole yhteyksiä esim. lääketeollisuuteen. Esim. kolesterolilääkkeen tarpeellisuutta tutkinut paneeli tuli siihen tulokseen että n. 25 % amerikkalaisista, jopa sellaisista henkilöistä jotka olivat terveitä, tarvitsee statiinia."
http://www.beforeyoutakethatpill.com/in ... uidelines/
Feb
03
2009
How Much You Gonna Pay Me For Those Medical Guidelines?
There is an editorial in this weeks issue of JAMA by Drs. Sniderman and Furberg on the issue of medical guidelines, something that I have written about before, for example about how the National Cholesterol Education Panel (NCEP) came up with guidelines that would put 25% of the American population on statins, even if they were well. As I have written about before, men with few risk factors for heart disease and women without heart disease have no demonstrable benefit from taking statins, unless you have a relative who own stock in drug companies. Also countries like New Zealand (or any other rational country for that matter), who would put half as many people on statins per their guidelines, have NO differences in HEART disease mortality from the US. Which means that there is something definitely wrong with this picture.
Rumours have it that Dr. Furberg once received death threats for his audacious role in pointing out the dangers of drugs like Vioxx, and I have written in my book quoting him.
Dr Curt Furberg testifying to congress on problems with med guidelines
In this week?s editorial, they write:
Doctors often feel entitled to, e.g. get lucrative speaking fees from the companies affected by the guidelines that they are writing, or to get freebies and dinners. But I think the American public is getting fed up. So for the doctors out there, here is a free bic pen that doesn?t have any drug advertising on it.
The anchoring authority of the guideline process is the belief that guidelines are evidence based, not opinion based, and therefore their conclusions flow directly from the conclusions of studies.
In other words, doctors assume (incorrectly) that guidelines are written by objective observers who are not serving as proxies for the pharmaceutical industry. In addition to conflict of interest issues, the writers point out that the guidelines do not undergo peer review, are not made available on the internet for public comment, are typically written by MDs with no epidemiologists or statisticians on the committees, inappropriately represent areas of uncertainty as definite, and serve as spring boards for doctors to go on to lucrative speaking careers funded by pharma based on the prestige of having been on the committees. They correctly point out that saying you consult to all drug companies and therefore do not favor any one of them in particular is not a valid argument. They argue for full disclosure of companies and amounts earned.
"Ennen kuin otat lääkettä - sinun kannattaa tutustua huolellisesti valmisteeseen ja seuraavan artikkelin mukaan myös heidän sivuillaan olevaan tietoon lääkkeistä ja miten niiden käyttöön liittyviä hoitosuosituksia tehdään. Hoitosuositusten laatimisessa painotetaan niiden pohjautuvan puhtaasti tieteellisiin tosiasioihin eikä mielipiteisiin, mutta .. Useimmat lääkärit kuvittelevat virheellisesti, että hoitosuositukset on laatinut objektiivinen paneeli jolla ei ole yhteyksiä esim. lääketeollisuuteen. Esim. kolesterolilääkkeen tarpeellisuutta tutkinut paneeli tuli siihen tulokseen että n. 25 % amerikkalaisista, jopa sellaisista henkilöistä jotka olivat terveitä, tarvitsee statiinia."
http://www.beforeyoutakethatpill.com/in ... uidelines/
Feb
03
2009
How Much You Gonna Pay Me For Those Medical Guidelines?
There is an editorial in this weeks issue of JAMA by Drs. Sniderman and Furberg on the issue of medical guidelines, something that I have written about before, for example about how the National Cholesterol Education Panel (NCEP) came up with guidelines that would put 25% of the American population on statins, even if they were well. As I have written about before, men with few risk factors for heart disease and women without heart disease have no demonstrable benefit from taking statins, unless you have a relative who own stock in drug companies. Also countries like New Zealand (or any other rational country for that matter), who would put half as many people on statins per their guidelines, have NO differences in HEART disease mortality from the US. Which means that there is something definitely wrong with this picture.
Rumours have it that Dr. Furberg once received death threats for his audacious role in pointing out the dangers of drugs like Vioxx, and I have written in my book quoting him.
Dr Curt Furberg testifying to congress on problems with med guidelines
In this week?s editorial, they write:
Doctors often feel entitled to, e.g. get lucrative speaking fees from the companies affected by the guidelines that they are writing, or to get freebies and dinners. But I think the American public is getting fed up. So for the doctors out there, here is a free bic pen that doesn?t have any drug advertising on it.
The anchoring authority of the guideline process is the belief that guidelines are evidence based, not opinion based, and therefore their conclusions flow directly from the conclusions of studies.
In other words, doctors assume (incorrectly) that guidelines are written by objective observers who are not serving as proxies for the pharmaceutical industry. In addition to conflict of interest issues, the writers point out that the guidelines do not undergo peer review, are not made available on the internet for public comment, are typically written by MDs with no epidemiologists or statisticians on the committees, inappropriately represent areas of uncertainty as definite, and serve as spring boards for doctors to go on to lucrative speaking careers funded by pharma based on the prestige of having been on the committees. They correctly point out that saying you consult to all drug companies and therefore do not favor any one of them in particular is not a valid argument. They argue for full disclosure of companies and amounts earned.