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Stockpiling drugs unnecessary
Mar. 11, 2006. 01:00 AM
Q
I'm a health care provider, working at one of the hospitals where SARS was a problem. I don't feel we were well enough equipped to deal with SARS, and I'm afraid that when the avian flu pandemic comes it will be the same story. Because of my connections, I can easily lay in enough Tamiflu to protect myself and my family. But I'm morally opposed to stockpiling drugs "just in case" ? and would never advise my patients to do so. Can I make a case for keeping a supply based on the idea that, if I don't stay healthy, I can't take care of my patients?
A
SARS was a wake-up call for Ontario. We were not just short of masks and beds; we also lacked a coherent, thought-out ethical framework for making difficult decisions ? some of them unprecedented in modern Canada.
One of the most difficult questions was "As a society, can we expect health care professionals to care for sick people, when we can't offer them satisfactory protection against the disease?" And there were others about how much suasion could be used to enforce quarantines, when and how to limit personal freedoms, and so on.
Since SARS, several groups have worked to build an ethical framework for dealing with these questions. The U of T's Joint Centre for Bioethics has published a comprehensive study called (unfortunately) Stand on Guard for Thee, and Ontario's Ministry of Health has developed a Pandemic Preparedness Policy based in part upon the ethical principles outlined there. You can read the government's policy at http://www.health.gov.on.ca.
The Ontario Government has a goal of stock-piling sufficient anti-virals to manage a pandemic until such time as a vaccine might be developed, potentially four months or more. And the process says that you, as a front-line health care worker, would be among the first to receive the drugs prophylactically ? which means, I gather, you wouldn't need to be sick to get them, but would be issued them to prevent getting sick. As a doctor you already knew that; as a lay-person, I thought "prophylactically" meant the drugs came inside a condom! So personal stock-piling should not be necessary; worse, it likely contributes to the atmosphere of ambient anxiety that already surrounds the flu threat. Given that anti-viral drugs stale-date fairly quickly, hoarding is probably not even wise. But that depends, in the end, on whether you trust the system ? and some who were involved in the SARS episode don't, and likely never will.
Mar. 11, 2006. 01:00 AM
Q
I'm a health care provider, working at one of the hospitals where SARS was a problem. I don't feel we were well enough equipped to deal with SARS, and I'm afraid that when the avian flu pandemic comes it will be the same story. Because of my connections, I can easily lay in enough Tamiflu to protect myself and my family. But I'm morally opposed to stockpiling drugs "just in case" ? and would never advise my patients to do so. Can I make a case for keeping a supply based on the idea that, if I don't stay healthy, I can't take care of my patients?
A
SARS was a wake-up call for Ontario. We were not just short of masks and beds; we also lacked a coherent, thought-out ethical framework for making difficult decisions ? some of them unprecedented in modern Canada.
One of the most difficult questions was "As a society, can we expect health care professionals to care for sick people, when we can't offer them satisfactory protection against the disease?" And there were others about how much suasion could be used to enforce quarantines, when and how to limit personal freedoms, and so on.
Since SARS, several groups have worked to build an ethical framework for dealing with these questions. The U of T's Joint Centre for Bioethics has published a comprehensive study called (unfortunately) Stand on Guard for Thee, and Ontario's Ministry of Health has developed a Pandemic Preparedness Policy based in part upon the ethical principles outlined there. You can read the government's policy at http://www.health.gov.on.ca.
The Ontario Government has a goal of stock-piling sufficient anti-virals to manage a pandemic until such time as a vaccine might be developed, potentially four months or more. And the process says that you, as a front-line health care worker, would be among the first to receive the drugs prophylactically ? which means, I gather, you wouldn't need to be sick to get them, but would be issued them to prevent getting sick. As a doctor you already knew that; as a lay-person, I thought "prophylactically" meant the drugs came inside a condom! So personal stock-piling should not be necessary; worse, it likely contributes to the atmosphere of ambient anxiety that already surrounds the flu threat. Given that anti-viral drugs stale-date fairly quickly, hoarding is probably not even wise. But that depends, in the end, on whether you trust the system ? and some who were involved in the SARS episode don't, and likely never will.