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American Medical System and Vioxx

So you believe in the faith based powers of Benny Hinn? He gets people to stop medication and give their health to god. Clearly if this didn't work people would complain about the preventable deaths of their loved ones.
What does Benny Hinn have to do with Edgar Cayce?

It must work, we need faith healers not doctors.
Since Cayce wasn't a faith healer, what's your point?
 
It is also unfortunate that it had the side-effects it did. My doctor has never found anything that worked as well for my arthritis. Almost completely alleviated the symptoms

that's correct for me as well but instead of Vioxx I use Celebrex ( sparingly ) and it is on the market without the severity of the Vioxx heart issues and yet using the same mechanism for pain relief.
And Merck tried to cover up the issue with its version.

That in my books puts Merck as culpable.

The ongoing knee jerk defence of the drug/mainstream medical industry ( well it helped a lot of people and killed a bunch too ) and red herring of "supplements" is wearying.

Preventable errors kill 100,000s needlessly every year - it does not matter how many are helped if the errors are preventable. Nations including my own have targetted this reality with good results.
In my cancer treatment this last summer it was sometimes annoying with the repetitive confirming of my birthdate etc and showing me my name on the drub pack.
But I was patient as I understood that swapping a bag of chemo by accident could easily harm or kill someone.
The rote repetitive checking of patient against drug gve me confidence that all along the line in the preparation etc the same careful attention was being paid.

THIS issue with Vioxx in my view was preventable as Celebrex has shown. This is no con job over an ineffective drug....the COX2 inhibitor works wonders. I can still recall the first time I took a Celebrex and the reaction was - so this is what it's like to be painfree....I'd forgotten.

The issue with inadequate testing for Vioxx is regrettable - the cover up is criminal in my opinion.
•••

Take the Cayce puerile bickering and shove it somewhere else:mgbanghead
 
The ongoing knee jerk defence of the drug/mainstream medical industry ( well it helped a lot of people and killed a bunch too ) and red herring of "supplements" is wearying.

Yeah, you won't get any argument from health care professionals that continuing to develop and use strategies to prevent error (as well as adverse effects) is an excellent idea. So I'm not sure what the point was of bringing up an example of how adverse effects were identified and acted upon (i.e. Vioxx). Knowing Rodney, I'm pretty sure that it wasn't meant to be an example of the system working, though. The issue of supplements or of Cayce are examples of a system that doesn't work, for comparison. I will admit that I am still wondering what Rodney's point is with the OP.

Linda
 
Preventable errors kill 100,000s needlessly every year - it does not matter how many are helped if the errors are preventable. Nations including my own have targetted this reality with good results.
Ooo geee... Took me five minutes to figure out how idiotic that statistic is. Would anyone like to raise their hands and point out how idiotic this statistic is? Supremely idiotic is this statment.
 
Ooo geee... Took me five minutes to figure out how idiotic that statistic is. Would anyone like to raise their hands and point out how idiotic this statistic is? Supremely idiotic is this statment.

I have explained in detail to Macdoc why that statistic is idiotic several times in the past. It says a lot about her/him that she/he continues to quote it anyway.

Linda
 
I will admit that I am still wondering what Rodney's point is with the OP.


I was guessing that it was "Big Pharma bad therefore sCAM good".

The fact that medical treatments can have unexpected adverse effects (or expected ones, for that matter) is so uncontroversial as to not be worth making on its own.

And the implication that sCAM does not have adverse effects is, of course, false.
 
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I have explained in detail to Macdoc why that statistic is idiotic several times in the past. It says a lot about her/him that she/he continues to quote it anyway.

Linda
Can you state your reason why? I'm pretty sure its the same reason that I have as that the definition of mistake is missing. Medicine overlaps with the entire field of engineering. When most people think of medical mistake they think of accidentally giving someone the wrong medicine or cutting off the wrong limb. I'm an engineer. Mistake to me includes leads popping off medical devices, and accidental electrocution.
 
I will admit that I am still wondering what Rodney's point is with the OP.
The main point is that drugs are often-times prescribed without knowing all of the ramifications of their use, and sometimes those ramifications prove extremely deleterious, if not fatal.
 
The main point is that drugs are often-times prescribed without knowing all of the ramifications of their use, and sometimes those ramifications prove extremely deleterious, if not fatal.

So what?

Linda
 


The patient/doctor relationship is founded on trust (philosophically and legally). It's fine that doctors don't always describe in painstaking detail all the possible ramifications of their decisions -- most people wouldn't understand anyway. But there are always times when patients need to weigh risks and make informed decisions and being in a position of trust also entails the responsibility on the part of the doctor to help those patients make an informed decision.

This was doubly screwed up in the case of Vioxx because the doctors have a similar relationship with pharmaceutical companies and the FDA and they weren't fully informed either. But even if they were, when someone comes into your office and complains about stomach pain because of their arthritis medication and you change it to a medication that significantly raises their chances of a heart attack or stroke and you don't tell them about those risks, you're at fault because the patient relies on the doctors to tell them these things.

That's so what. The gravity of the situation may vary, but the principle is there.
 
Can you state your reason why? I'm pretty sure its the same reason that I have as that the definition of mistake is missing. Medicine overlaps with the entire field of engineering. When most people think of medical mistake they think of accidentally giving someone the wrong medicine or cutting off the wrong limb. I'm an engineer. Mistake to me includes leads popping off medical devices, and accidental electrocution.

Adverse effects or events are those which are undesirable and detrimental.

Errors are mistakes in diagnosis or treatment.

Preventable errors are those which could be avoided or could reasonably be recognized.

Preventable deaths are those involving an error in which avoidance of the error would avoid the death.

Adverse effects or events are often not due to error. Errors are often not preventable. Deaths are often not avoidable regardless of whether or not a preventable error has occurred. In the end, what is of most interest is whether or not more people survive in the presence of an intervention or in its absence.

For example, the woman who died from a heart attack on rofecoxib may have died from a perforated ulcer on naproxen in the absence of rofecoxib.

Plus the studies Macdoc has referenced in the past as supporting her/his assertions are not measuring preventable error, let alone preventable death.

Linda
 
The patient/doctor relationship is founded on trust (philosophically and legally). It's fine that doctors don't always describe in painstaking detail all the possible ramifications of their decisions -- most people wouldn't understand anyway. But there are always times when patients need to weigh risks and make informed decisions and being in a position of trust also entails the responsibility on the part of the doctor to help those patients make an informed decision.

This was doubly screwed up in the case of Vioxx because the doctors have a similar relationship with pharmaceutical companies and the FDA and they weren't fully informed either. But even if they were, when someone comes into your office and complains about stomach pain because of their arthritis medication and you change it to a medication that significantly raises their chances of a heart attack or stroke and you don't tell them about those risks, you're at fault because the patient relies on the doctors to tell them these things.

That's so what. The gravity of the situation may vary, but the principle is there.

Yes, informed consent is important. Is any of that under dispute?

Linda
 
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Why are you under that impression?

[...]

I don't know. I'm still trying to figure out what the point is of stating the obvious.


I've done a lot of research into the Merck/Vioxx thing (for bioethics classes) and whenever I see what seems like a defense of Merck, my hackles go up. When lives are at stake, there is no defense for taking honesty out of any part of the process, which they did. The rules governing human experimentation are currently and arguably more stringent than the ones governing what can be prescribed legally, which can at times at best be seen as paradoxical.

But I probably haven't read the thread carefully enough, I admit.
 
I've done a lot of research into the Merck/Vioxx thing (for bioethics classes) and whenever I see what seems like a defense of Merck, my hackles go up.

I provided a bunch of links to the editorials which appeared in the NEJM outlining the course of events and the concerns raised. In what way was that a defense of Merck?

Linda
 
I provided a bunch of links to the editorials which appeared in the NEJM outlining the course of events and the concerns raised. In what way was that a defense of Merck?


I don't know? What initially got my attention was you saying "so what" to a statement suggesting that drugs are "often-times prescribed without knowing all of the ramifications of their use", which often can prove harmful or fatal.

"So what" can mean a couple of things. It can mean that you think it's obvious and are questioning why anyone would bother to state it, which is, well, kind of a jerky thing to say under any circumstances, let alone at an educational foundation where not everyone is necessarily aware of it.

But "so what" can also and usually does indicate that the statement in question isn't seen as a problem, as in "it's OK that drugs are prescribed without knowing or communicating the associated risks". Which is, you know, kind of dumb.

Why so hostile?
 
I don't know? What initially got my attention was you saying "so what" to a statement suggesting that drugs are "often-times prescribed without knowing all of the ramifications of their use", which often can prove harmful or fatal.

"So what" can mean a couple of things. It can mean that you think it's obvious and are questioning why anyone would bother to state it,

And since that is what I said in the post Rodney responded to, it would make sense to think that was what I meant.

which is, well, kind of a jerky thing to say under any circumstances, let alone at an educational foundation where not everyone is necessarily aware of it.

Oh my. It's too much pressure if everything I say should be educational. :)

But "so what" can also and usually does indicate that the statement in question isn't seen as a problem, as in "it's OK that drugs are prescribed without knowing or communicating the associated risks". Which is, you know, kind of dumb.

Yeah, that should be a clue.

Why so hostile?

Huh?

Linda
 
The main point is that drugs are often-times prescribed without knowing all of the ramifications of their use, and sometimes those ramifications prove extremely deleterious, if not fatal.

Same goes for peanut butter, and I'm not talking just allergic reactions. Remember the Peter Pan recall? Hundreds or even thousands of people got sick and several died. I got hit. Truth is, I like peanut butter. No, I love it, and I love Peter Pan. I had several jars subject to recall. By the time I learned about the recall, I had finished one jar and was halfway through a second. I finished that one and played the odds by opening the third. While I did not get a confirmation of salmonella, my self-diagnosis coupled with the known contamination is enough for me. It was rough.

The point is that everything we do in life is a matter of risk management, from stepping into the shower to driving a car to buying a hot dog from a street vendor. To point out that medicines present risks is as useful as pointing out that the sky is blue.

If you want to offer something of value, discuss the risk management itself. When you do, be prepared to talk about "acceptable" losses. They can't swab every square inch of the peanut butter factory every single day. Even if they did, they could still miss contamination. Are they to test every single jar? If so, they have different sized jars, so do they check each half of the larger jars?

FLS posted some articles with valuable insight into where things went wrong and what steps could be taken to reduce but not eliminate risk. And as Pax said, there are pros and cons that need to be weighed. So, Rodney, if your only point is that the sky is blue, then I guess FLS said it all when she asked, "so what?"
 

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