A no win situation for doctors

I know, but that doesn’t mean he or his wife should get to make demands of medical professionals they wouldn’t otherwise be entitled to. The government can’t infringe my right to the free exercise of religion, but that doesn’t mean I’m entitled to a ride to church.

But can a court order a minister to preach the sermon of your choice?

… I’m not sure what point you’re trying to make.

This. It’s the reason clinical trials are so very, very tightly controlled and the data scrutinized so thoroughly.

It’s also why they tend to be very large. Years ago I saw a write-up from a person with MS in which they did the math to show how big of a clinical trial you would need in order to demonstrate, with high statistical confidence, that a hypothetical new medicine being tested was actually making a difference in disease outcome. The challenge was related to how “noisy” MS is: there’s a huge range of outcomes when the disease is left untreated, thus the need for a large (and expensive) clinical trial. The same would be true for assessing the merits of Ivermectin for treating COVID, since COVID likewise has a large range of outcomes without treatment, ranging all the way from asymptomatic to dead. One clinician treating a handful of patients can’t draw any meaningful conclusions about the efficacy of Ivermectin from his experiences.

Sure, it’s conceivable that maybe Ivermectin really does something, and conceivable that it might help this schlub. But the thing is, you can say that about lots of things: There’s just as much evidence that aloe vera, or kale, or rattlesnake venom is effective against covid. And any court that ordered doctors to administer rattlesnake venom would absolutely, 100% be wrong.

That’s correct. Both drugs were not being used investigationally as cures for COVID, but rather for the management of symptoms.

Many years ago, I saw a TV show, on “20/20” or something similar long before they became true crime shows, about people who practiced undernutrition as a life-extending measure. This is, of course, of dubious efficacy, but I remember one man who lived on several pounds of fresh raw greens daily, and not much else. His wife said she was willing to go along with it if he did his own food preparation, which he did, but she did continue to cook “normal” meals for herself and their kids. This man did not look healthy either, and his doctor said he had very severe osteoporosis, and (this was actually his wife’s biggest issue with it) his sex drive had dwindled to just about zero. He wasn’t impotent; he could perform, but he didn’t really care any more, and SHE had a bigger issue with it than he did.

I agree, and if he’s been on a ventilator that long, it’s unlikely that he will come off it alive, and if he does, he may well be left permanently disabled.

So…does Ivermectin come in an IV form? I’ve heard of pills and apple flavored paste but he can’t take either of those if he’s not even conscious. Presumably they can’t just shoot him up with the sheep dip version either.

Maybe? I found an article that mentioned someone taking some (by mouth) that was an injectable form intended for cattle.
Whether or not that would be suitable (and safe) for a human, I don’t know and I’m only seeing pills and topicals for humans.

Perhaps they can be dissolved into a liquid and pushed through a feeding tube. Is that a thing? I can only assume there are other meds only available in oral form that need to be given to coma (or otherwise sedated) patients.

Yes, it’s a thing. I too could only find it in tablet (oral) dosage forms for humans.

The woman did have to sign a release form, at least.

As part of the complaint filed to the judge, Julie Smith signed a full release that relieved West Chester Hospital of any liability related to the ivermectin treatment. Davidson told The Post on Tuesday that Jeffrey Smith “hasn’t gotten any worse” eight days into his treatment.

Sounds like the old saw about a cold left untreated will last about a week but if you take any of various remedies it will be over in seven days.

Exactly!

Since I started this thread, I thought I would clarify a few things. First of all, while this situation irritates me as a physician, the doctors are technically not involved in this case. The hospital was sued and forcing them to give the medication falls upon the pharmacists who need to provide it and the nurses who need to administer it. Since the court is accepting the prescription of an outside physician, the doctors will not technically need to order it.
Second, I do understand that desperate people who have reached the limit of current accepted treatment may turn to experimental or unproven therapies and to some extent I do believe that they have that right. However, you should not be able to force medical personnel to provide these treatments against their better judgements.If the wife wanted to take the patient home and administer experimental therapy there, I would say it would be her right.
Finally, with regard to the community physician who is prescribing ivermectin for people with mild Covid, I would like to know if he is also prescribing the known, studied and effective treatments that we have available. If he is not offering monoclonal antibodies to every eligible patient with mild disease and instead only prescribing ivermectin then I have no sympathy if he is sued or censured by his Medical Board. I have had a terrible time trying to get people to get the monoclonal antibodies. The truth is that most people will get well with or without them just as most will get well with or without ivermectin or hydroxychloroquine or even fluvoxamine ( which nobody is talking about but has double blind studies in process, is a cheap and readily available oral medication that is relatively safe and actually shows some promise in early studies). That does not mean that we do not give patients all the appropriate options including educating them on the risks and benefits of both proven and unproven therapies.

Exactly. I wouldn’t mind if this was about hospital workers saying “this guy is dying anyways. Let’s try ivermectin. Contact his next of kin to see if she’s okay with it.”

But the issue is that said next of kin went to a quack doctor who doesn’t even serve at the hospital and got a prescription for the drug, and then a court stepped in and said that the hospital has to administer that drug, despite their belief it would do more harm than good.

It’s one thing for doctors not to be able to use something the patient (or their representative) has said not to use. It’s another for the patient to be able to force the doctors to use something they believe is contraindicated, especially when that something has not been approved for that usage.

And, from what I can tell, the studies all indicate that this is unlikely to be useful in humans, just like any other virus it has worked against in vitro. The level necessary to fight the virus successfully in the petri dish is higher than the level at which the drug becomes toxic in the human body, by orders of magnitude. And studies about reducing actual symptoms have been very weak, other than a single study that turned out to be fraudulent—as in you could see the data was copy-pasted.

Here ya go:
I-MASK+ Prevention & Early Outpatient Treatment Protocol for COVID-19
MATH+ Hospital Treatment Protocol for COVID-19
I-RECOVER Management Protocol for Long Haul COVID-19 Syndrome

Here’s a link to their protocols. Treatment Protocols - FLCCC Alliance

Thanks for clarifying. I hadn’t really thought about the details of who was involved.

I thought I’d mention that a friend got monoclonal antibodies in March, when she got covid. She probably caught covid from her kids, although they never had symptoms. She and her husband got sick around the same time. He had mild cold symptoms and she was quite ill. She’s very obese, which is probably relevant. Her mother (not her doctor) suggested she try monoclonal antibodies and gave her a link to a place that infused them. She reached out to her doctor who wrote the required prescription/recommendation for her to get them.

She thinks they saved her from more serious illness. She says, “maybe i wouldn’t have gotten sicker anyway, but i stopped getting any worse right after getting them”.

The only place I see monoclonal antibodies mentioned is in Early Treatment Protocol (for delta variant) and it specifies you must have at least one of the following factors: Age > 65y; obesity; pregnancy; chronic lung, heart, or kidney disease; diabetes; immunosuppressed; developmental disability; chronic tracheostomy; or feeding tube.

Also, there’s a 58 page PDF in the link to all their protocols. Doing little more than a Ctrl-F search for monoclonal, I see that most of the times it’s mentioned, it’s mentioned in places under ‘not recommend’ or ‘no benefit’, often in the same sentence as ‘convalescent serurm’. I’ll give you three guesses as to what’s listed in the Highly Recommended column. Fun fact, if one of your guesses is ‘essential oils’, you won’t be completely wrong.

Regarding the essential oils, I looked at the paper that was based on and, while I’m not qualified to read something like this, if I’m reading it correctly, they made it sound like it might help with some of the symptoms, that’s about it.

However, to be fair, it seems like he was suggesting vapo-rub as a preventative method hoping to kill the virus while it was still in your nose/mouth before it actually gets into your system. While that may have some merit, having the word ‘essential oils’ in your protocols is going to get the attention of a lot of lay-people, like myself.

As I noted in the other ivermectin thread, this is the same group that was absolutely certain hydroxychloroquine was the answer a year ago, but have tried to hide that fact now that they are pushing ivermectin.