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We generally trust doctors to give us medications and advice that help us, and ingest what they prescribe.

by bepvte 6y ago

sneak 6y ago
The fact remains that the ultimate responsibility for what goes into the body of a functioning adult who is not coerced in any way lies solely with that adult. We fault the individual when they don't take their medicine. Why do we fault their physician when they do? State licensing has confused the issue and made most people misplace the "authority" in this chain of events. Your doctor is NOT the authority on what goes into your body: you are.
- orf 6y ago
  That’s a silly argument to make because it completely ignores reality. Sure: nobody forced those pills into their mouths. But when you go to the doctor and say “I have this issue, please help me” and the doctor says “take this and it will help you”, clearly that’s something. Especially if that thing will actually not help you in the long run, and a large company knew that. When you’re dealing with large numbers of people, instructed by an authority figure, who is in turn influenced by a third party, with an end result that lives are ruined, then corporate pandering in the form of “everyone had a choice!!” seems rather odd because it clearly doesn’t absolve the doctors or the third party of any responsibility.
  - SpicyLemonZest 6y ago
    I'm not tremendously concerned about absolving anyone. What I'm concerned about is a world where the many people who legitimately need pain medication won't be able to get it, because we've told doctors that prescribing pain meds to people in pain is unacceptable behavior.
- xoa 6y ago
  >The fact remains that the ultimate responsibility for what goes into the body of a functioning adult who is not coerced in any way lies solely with that adult. This is horseshit sneak. You know it's horseshit. You're on HN, you deal with tech all the time. Would you say that responsibility for any security flaws or leaks in software lies solely with the "functioning adult who is not coerced in any way to install it"? Individually we're humans, we have fixed brain size and thermodynamics and thus have hard absolute limits on the total amount of information we can ever know and much much tighter limits on the rate at which we can ingest new information, process it, or make decisions. It is impossible for a human brain to be in charge of everything in modern society. IMPOSSIBLE. There is not enough time in a day, not enough days in a lifetime, to learn more than the tiniest fraction of what all of us use constantly. We deal with that by massively externalizing onto other people/organizations and trust frameworks, and then working to ensure there can be enough confidence in those. So responsibility is absolutely a spectrum, in medicine, in tech, everywhere. We cannot verify it all ourselves. Something must involve external relationships, and those external relationships are themselves two way aren't they? In a relationship, BOTH sides have responsibilities. >We fault the individual when they don't take their medicine. Why do we fault their physician when they do? Um, because it's a two-way relationship? The patient's part of it is to seek external expertise, and then follow through on expert instructions. The medical expert's part of it is to faithfully give instructions that are wholly in the patient's best interests to the best of their knowledge and capability, without any self-interest beyond the remuneration the patient offers for said service. >Your doctor is NOT the authority on what goes into your body: you are. As vacuous as claiming car manufacturers are not the authority on what you drive or it should be fine for food/medicine/anything manufacturers to lie about what goes into their products because hey, your fault for not verifying it. No, that's not how any of this works.
  - hilbert42 6y ago
    'This is horseshit sneak. You know it's horseshit. You're on HN, you deal with tech all the time.' Good one, precisely spot on! :-)
  - sneak 6y ago
    > This is horseshit sneak. You know it's horseshit. Not only is that plainly false (these are my sincerely held beliefs), it’s also not in any way a refutation of my claim. > You're on HN, you deal with tech all the time. Would you say that responsibility for any security flaws or leaks in software lies solely with the "functioning adult who is not coerced in any way to install it"? Yes, the ultimate responsibility for the code that my computer executes lies with me. I chose each and every piece of it, much of it with a context of ignorance.
SpicyLemonZest 6y ago
That's the point. Oxycontin did help people! A lot of people are speaking as though it's an inherently terrible drug only used for abusive purposes, and that's just not true - for many people it was a valuable drug needed to address their legitimate pain problems.
- hilbert42 6y ago
  '...Oxycontin did help people!' Before OxyContin, there were any number of narcotic painkilling drugs from those that have to be injected to ones that can be swallowed as a tablet or capsule that are made by more reputable drug companies (and have been for decades). OxyContin didn't offer anything over these earlier drugs. Not only doctors but many of the lay public already know this. Even if the spurious/nebulous argument that OxyContin's action lasted longer or whatever, that the sheer number of alternatives would tailor for almost any patient's requirement. The corollary being that OxyContin offered nothing new of any significance. Even existing narcotics can be compounded for an individual patient's needs. The fact is that almost everyone knows this, especially doctors and pharmacists yet the medical profession let itself be bought off and FDA didn't even wink an eyelid to stop it. Where was the FDA's corporate memory? How did its 100+year history on this matter fly out the window as if it never existed? Essentially, in the light of a few dollars on offer from Sackler's/Purdue these damn miserable medicos said fuck the Hippocratic Oath and let their patients rot. The Sackler's and Purdue are ratbags, but also there's many a medico who should have his/her license to practice revoked.
  - SpicyLemonZest 6y ago
    I don't mean to excuse the medical establishment, since it was publicly known almost immediately after it was authorized that OxyContin was being abused. But it's my understanding that their core idea of controlled-release oxycodone really was innovative and impactful for legitimate purposes.
    - hilbert42 6y ago
      'But it's my understanding that their core idea of controlled-release oxycodone really was innovative and impactful for legitimate purposes.' Yeah, that's the bullshit they want you to believe. As I said, even if no older or more commonly available opiate were available that precisely matched OxyContin's duration/time release (which is a bit far fetched given the dozens others that were already available well before OxyContin was released), then any self-respecting corner-shop compounding pharmacist will blend a time release to suit any patient (or match one to Oxycontin's properties). Blending up a time-release drug requires a knowledge of the normal properties of said drug, an ability to calculate the additional amount of drug after its duration has been extended with delaying agents and the knowledge of the properties of any third drug needed (like another different opioid) if found necessary to add one so as to tweak or fine-tune the process. Sounds complicated, but it's a snack to do for someone with a degree in pharmacy.

We generally trust doctors to give us medications and advice that help us, and ingest what they prescribe.

by bepvte 6y ago

We generally trust doctors to give us medications and advice that help us, and ingest what they prescribe.

The fact remains that the ultimate responsibility for what goes into the body of a functioning adult who is not coerced in any way lies solely with that adult. We fault the individual when they don't take their medicine. Why do we fault their physician when they do? State licensing has confused the issue and made most people misplace the "authority" in this chain of events. Your doctor is NOT the authority on what goes into your body: you are.

orf 6y ago
That’s a silly argument to make because it completely ignores reality. Sure: nobody forced those pills into their mouths. But when you go to the doctor and say “I have this issue, please help me” and the doctor says “take this and it will help you”, clearly that’s something. Especially if that thing will actually not help you in the long run, and a large company knew that. When you’re dealing with large numbers of people, instructed by an authority figure, who is in turn influenced by a third party, with an end result that lives are ruined, then corporate pandering in the form of “everyone had a choice!!” seems rather odd because it clearly doesn’t absolve the doctors or the third party of any responsibility.
- SpicyLemonZest 6y ago
  I'm not tremendously concerned about absolving anyone. What I'm concerned about is a world where the many people who legitimately need pain medication won't be able to get it, because we've told doctors that prescribing pain meds to people in pain is unacceptable behavior.
xoa 6y ago
>The fact remains that the ultimate responsibility for what goes into the body of a functioning adult who is not coerced in any way lies solely with that adult. This is horseshit sneak. You know it's horseshit. You're on HN, you deal with tech all the time. Would you say that responsibility for any security flaws or leaks in software lies solely with the "functioning adult who is not coerced in any way to install it"? Individually we're humans, we have fixed brain size and thermodynamics and thus have hard absolute limits on the total amount of information we can ever know and much much tighter limits on the rate at which we can ingest new information, process it, or make decisions. It is impossible for a human brain to be in charge of everything in modern society. IMPOSSIBLE. There is not enough time in a day, not enough days in a lifetime, to learn more than the tiniest fraction of what all of us use constantly. We deal with that by massively externalizing onto other people/organizations and trust frameworks, and then working to ensure there can be enough confidence in those. So responsibility is absolutely a spectrum, in medicine, in tech, everywhere. We cannot verify it all ourselves. Something must involve external relationships, and those external relationships are themselves two way aren't they? In a relationship, BOTH sides have responsibilities. >We fault the individual when they don't take their medicine. Why do we fault their physician when they do? Um, because it's a two-way relationship? The patient's part of it is to seek external expertise, and then follow through on expert instructions. The medical expert's part of it is to faithfully give instructions that are wholly in the patient's best interests to the best of their knowledge and capability, without any self-interest beyond the remuneration the patient offers for said service. >Your doctor is NOT the authority on what goes into your body: you are. As vacuous as claiming car manufacturers are not the authority on what you drive or it should be fine for food/medicine/anything manufacturers to lie about what goes into their products because hey, your fault for not verifying it. No, that's not how any of this works.
- hilbert42 6y ago
  'This is horseshit sneak. You know it's horseshit. You're on HN, you deal with tech all the time.' Good one, precisely spot on! :-)
- sneak 6y ago
  > This is horseshit sneak. You know it's horseshit. Not only is that plainly false (these are my sincerely held beliefs), it’s also not in any way a refutation of my claim. > You're on HN, you deal with tech all the time. Would you say that responsibility for any security flaws or leaks in software lies solely with the "functioning adult who is not coerced in any way to install it"? Yes, the ultimate responsibility for the code that my computer executes lies with me. I chose each and every piece of it, much of it with a context of ignorance.

SpicyLemonZest 6y ago

That's the point. Oxycontin did help people! A lot of people are speaking as though it's an inherently terrible drug only used for abusive purposes, and that's just not true - for many people it was a valuable drug needed to address their legitimate pain problems.

hilbert42 6y ago
'...Oxycontin did help people!' Before OxyContin, there were any number of narcotic painkilling drugs from those that have to be injected to ones that can be swallowed as a tablet or capsule that are made by more reputable drug companies (and have been for decades). OxyContin didn't offer anything over these earlier drugs. Not only doctors but many of the lay public already know this. Even if the spurious/nebulous argument that OxyContin's action lasted longer or whatever, that the sheer number of alternatives would tailor for almost any patient's requirement. The corollary being that OxyContin offered nothing new of any significance. Even existing narcotics can be compounded for an individual patient's needs. The fact is that almost everyone knows this, especially doctors and pharmacists yet the medical profession let itself be bought off and FDA didn't even wink an eyelid to stop it. Where was the FDA's corporate memory? How did its 100+year history on this matter fly out the window as if it never existed? Essentially, in the light of a few dollars on offer from Sackler's/Purdue these damn miserable medicos said fuck the Hippocratic Oath and let their patients rot. The Sackler's and Purdue are ratbags, but also there's many a medico who should have his/her license to practice revoked.
- SpicyLemonZest 6y ago
  I don't mean to excuse the medical establishment, since it was publicly known almost immediately after it was authorized that OxyContin was being abused. But it's my understanding that their core idea of controlled-release oxycodone really was innovative and impactful for legitimate purposes.
  - hilbert42 6y ago
    'But it's my understanding that their core idea of controlled-release oxycodone really was innovative and impactful for legitimate purposes.' Yeah, that's the bullshit they want you to believe. As I said, even if no older or more commonly available opiate were available that precisely matched OxyContin's duration/time release (which is a bit far fetched given the dozens others that were already available well before OxyContin was released), then any self-respecting corner-shop compounding pharmacist will blend a time release to suit any patient (or match one to Oxycontin's properties). Blending up a time-release drug requires a knowledge of the normal properties of said drug, an ability to calculate the additional amount of drug after its duration has been extended with delaying agents and the knowledge of the properties of any third drug needed (like another different opioid) if found necessary to add one so as to tweak or fine-tune the process. Sounds complicated, but it's a snack to do for someone with a degree in pharmacy.