# Medical Ethics - as Required of MD's **URL:** \ **Category:** In My Humble Opinion\ **Created:** [March 16, 2017, 4:07am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287 "2017-03-16T04:07:56Z")\ **Posts on this page:** 20\ **Page:** 10
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [March 24, 2017, 2:29pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/181 "2017-03-24T14:29:40Z")
> [@DSeid](#): > > [Gives great thanks that I’m in peds and don’t have to deal with patients like this. Wow.] Makes those anxious new parents seem positively adorable, doesn’t it? Sent from my XT1585 using Tapatalk ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [March 24, 2017, 6:49pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/182 "2017-03-24T18:49:31Z")
I would imagine that all this drug use over time would’ve caused his insomnia, wouldn’t it, or at least made it worse. (It sounds like he’s been doing this since he was a teenager.) ---
**Author:** ![bobkitty](https://avatars.discourse-cdn.com/v4/letter/b/c67d28/32.png) [@bobkitty](https://boards.straightdope.com/u/bobkitty)\ **Post date:** [March 24, 2017, 8:12pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/183 "2017-03-24T20:12:33Z")
Many of the drugs he’s on can have a rebound effect, even after (or especially after) years of use. It’s like the people trying to get off Afrin; they use it, have great success, but over time the space between needing a dose gets shorter and shorter, until they’re using it all the time and their symptoms are just getting worse and worse. The mixing of multiple drug classes with alcohol would definitely make the insomnia worse. Something tells me he wasn’t completely up front with his doctors about the extent of his alcohol use. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 24, 2017, 8:33pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/184 "2017-03-24T20:33:53Z")
> [@DSeid](#): > > Oh that one comes from me. If I _was_ on adult-side certainly I’d refuse to care for him without a psychiatric evaluation as part of his care plan. > > Early adolescence onset severe insomnia. In teen years first rigging up a bedroom urinal then peeing out his bedroom window which to this day he sees as the rational and considerate thing to do. > As a matter of fact, yes - why did you not ask about what was required to get from my room to the only bathroom? No question of where the bathroom was located? How about the creaking stairs at 3:00 AM. But yeah - obviously psycho > > Hallucinogenics then alcohol use (only as self-medication man!) but of course a body too pure to defile with treatment for hypertension that was severe for as long as he can remember hearing the numbers (hate pills man!), > Did you (still) not note the etoh (booze) was for the insomnia? As to the acid - you’re just jealous you sat out the 60’s aren’t you? > > self-medication with otc drugs > Um - how do you use OTC’s? I’m going to guess (nearly) everybody buying an OTC is “self medicating” - that is exactly the purpose of OTC’s., right? > > and use of powerful prescription medications in manners other than as prescribed (WebMD and me!) > I had gabapentin prescribed for pain. by 3 different MD’s. Itch is a version of nerve pain. Using the gaba for itch would seem to fall under “as needed for pain”, wouldn’t it? > When informed that it had worked (and that the tip came from WebMD), PCP eagerly added it to my list and continued to prescribe it. > Now - let’s get specific here. You made a very serious charge of misusing “powerful prescription medications” - exactly where and when did I do any such thing? > > and seeking out providers who will continue to enable such behaviors, distrust and some contempt of health professionals other than to give him as much opioids and benzos as he can get, > Are you deliberately mis-stating me? > If I was out to get “as much opioids and benzos as he can get”, why did I discontinue the clonezepam? Why did I not use all the morphine and dilaudid as I got? > > self-assessments that are quite grandiose, posts that are expansive and full of flight of ideas and some thinking that at least seems delusional. > I’d REALLY like an explanation of that one. > I do not claim any knowledge that is not backed by at least 3 MD’s and/or the research posted on WebMD and other reputable ([kidney.org](http://kidney.org), etc) sites > > I know what I think that is until proven otherwise. What _you_ think is _your_ problem, not mine. Accusations of deliberate mis-use of prescription drugs should be either backed up or withdrawn ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 24, 2017, 8:43pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/185 "2017-03-24T20:43:46Z")
The OP has been asked and as answered as it is going to get. Before anyone else offers an “opinion” which charges me with a felony, I will ask this thread be put out of its misery. But - feel free to take this to the Pit and call me all the names you want. usedtobe - drug seeking addict with undiagnosed psychiatric problems. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [March 24, 2017, 8:46pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/186 "2017-03-24T20:46:56Z")
> [@bobkitty](#): > > … Something tells me he wasn’t completely up front with his doctors about the extent of his alcohol use. Something tells me you are talking out of your ass and are not qualified to offer an opinion. ---
**Author:** ![bobkitty](https://avatars.discourse-cdn.com/v4/letter/b/c67d28/32.png) [@bobkitty](https://boards.straightdope.com/u/bobkitty)\ **Post date:** [March 24, 2017, 8:58pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/187 "2017-03-24T20:58:52Z")
Yeah, I’m actually going to believe you when you say you were completely honest about allegedly mixing “Cheap beer (Old Milwaulkee was $1.29 cold)” and “100 proof Stoli” plus Unisoms with your other medications for almost 30 years and your doctors had no problem with it. Uh huh. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [March 24, 2017, 9:45pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/188 "2017-03-24T21:45:34Z")
> [@usedtobe](#): > > What _you_ think is _your_ problem, not mine. Accusations of deliberate mis-use of prescription drugs should be either backed up or withdrawn Fortunately my problems (and I have some of course) have nothing to do with what I think about your posts and are fairly minor, and the interest I have in this thread has become learning from the other healthcare professionals about dealing with dysfunctional patients with your pathology as a case example. Your posts are my cites for what I have stated otherwise. It is understood that you believe that your behaviors, your self-medication, and posts have all been completely sane, rational, and appropriate. The rest of us are, to your view of reality, just idiots, and your doctors are servants who should just do what you tell them to do. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [March 24, 2017, 10:57pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/189 "2017-03-24T22:57:40Z")
I don’t know, I’d probably rather be woken up by creaking steps than have to deal with the stench of piss in the bushes. But that’s just me. Dude, seriously – I’m not an expert, but one thing I have heard, multiple times, is that sleeping pills can actually contribute to insomnia. If you WERE weaned off of them, eventually you most likely wouldn’t need them, or at least, not all the time, and not nearly as high a dose. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [March 24, 2017, 11:37pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/190 "2017-03-24T23:37:07Z")
> [@usedtobe](#): > > The doc who passes out lethal level of morphine didn’t mention magnesium because she was afraid IT would damage my kidneys? Why do you refuse to take any personal responsibility for the state of your kidneys? You like to portray yourself as a very informed, educated patient, _yet_ you apparently were happy to continue to use the morphine and never even ask about the long term effects it might have on your kidneys. You can’t have it both ways. You can’t consider yourself to be an educated, involved patient but at the same time claim total and utter ignorance of what was happening to you. ---
**Author:** ![raventhief](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/raventhief/32/4_2.png) [@raventhief](https://boards.straightdope.com/u/raventhief)\ **Post date:** [March 24, 2017, 11:45pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/191 "2017-03-24T23:45:47Z")
> **[NO Kidding, Doc, Really! Thanks Sooo much.](https://boards.straightdope.com/sdmb/showthread.php?t=732829)** > > I just sent a bitter email to my doc. Just in case you’ve forgotten - I have Osteoarthritis - the deterioration of the cartilage between bones. The resultant pain has been compared to un-medicated childbirth. After a DEA clampdown, Doc cuts me... Thread from 2014 - DEA clampdown, morphine is cut, and the OP is told in that thread how very, very bad morphine is for CKD. AND is told repeatedly to find a pain management specialist. ---
**Author:** ![bobkitty](https://avatars.discourse-cdn.com/v4/letter/b/c67d28/32.png) [@bobkitty](https://boards.straightdope.com/u/bobkitty)\ **Post date:** [March 24, 2017, 11:58pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/192 "2017-03-24T23:58:36Z")
Interesting: > [@](#): > > Either way, any other doc is going to be under the same rules. Mine is probably in the crosshairs due to her habit of making sure the pain is dead. I came in with a 'script for 240 hydromorphone 4 mg (which was no longer enough) and left with 45mg time-release morphine. I suspect she was supposed to try me at minimum dosage and work up. Or she does the morphine thing so often that she can make the “opiate equivalency” calc on the spot, in her head. > Either way, she may be in for “enhanced scrutiny” from whoever. > > And there is the ethical problem: if she isin trouble because she was over-generous with me, how can I desert her? If a whole bunch of her patients are getting opiates, and they all leave, her practice is ruined. So he saw this coming and had decided to stick it out because she was ‘over-generous’ and he didn’t want to desert her. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [March 25, 2017, 12:23am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/193 "2017-03-25T00:23:32Z")
> [@usedtobe](#): > > Something tells me you are talking out of your ass and are not qualified to offer an opinion. I think the only “qualification” needed to give such an opinion is literacy. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [May 3, 2017, 4:29am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/194 "2017-05-03T04:29:43Z")
> [@raventhief](#): > > [NO Kidding, Doc, Really! Thanks Sooo much. - In My Humble Opinion - Straight Dope Message Board](http://boards.straightdope.com/sdmb/showthread.php?t=732829) > > Thread from 2014 - DEA clampdown, morphine is cut, and the OP is told in that thread how very, very bad morphine is for CKD. AND is told repeatedly to find a pain management specialist. i called approx 5 local “Pain Practices”. For some reason, they declined to treat a 67 yr old male with kidney failure and relying on morphine overdoes for pain control. on Medicare. Referred by hack MD. Surprising. The duty to find equivalent treatment lay with her, not me. Her instruction was oral, not a prescription. Mayhaps you should do a bit of research before challenging. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [May 3, 2017, 4:42am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/195 "2017-05-03T04:42:42Z")
So I see you’re still alive. At least there’s that. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [May 3, 2017, 4:49am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/196 "2017-05-03T04:49:05Z")
p.S - 4/22/17 - rebound bradycardia occasioned by Acute Kidney Failure 2/16/17. Now do I get to be angry? I do not demand specific meds. I demand relief from OA and lifelong, continuous insomnia. Given my extreme problems fulfilling these requirements, I DO research and track meds. I have never demanded continuation of a drug - I require effective relief from symptoms; I tweak meds approx once per yr. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [May 3, 2017, 4:50am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/197 "2017-05-03T04:50:44Z")
> [@Ambivalid](#): > > So I see you’re still alive. At least there’s that. Hey! - this time I got the window bed! There’s that! ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [May 3, 2017, 4:54am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/198 "2017-05-03T04:54:52Z")
I must retire; bed calls. Found _new_ more friendly sleeper (marginal at best. surprise.). Given extreme fatigue, it may work tonight. Med range plan - leave CA. Tired of fighting for my freedom under a law which is questionable at best. CA 1550 - See! ---
**Author:** ![bobkitty](https://avatars.discourse-cdn.com/v4/letter/b/c67d28/32.png) [@bobkitty](https://boards.straightdope.com/u/bobkitty)\ **Post date:** [May 3, 2017, 2:09pm UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/199 "2017-05-03T14:09:16Z")
You were sectioned? Color me surprised (not). ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 4, 2017, 1:08am UTC](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287/200 "2017-05-04T01:08:09Z")
So tell us about your meeting with the lawyer and how your case for medical abandonment is going? [Previous page](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287.md?page=9) [Next page](https://boards.straightdope.com/t/medical-ethics-as-required-of-mds/782287.md?page=11)