Should Hospital Emergency Rooms STOP Treating Drug ODs?

Great Debates
21

Since everyone has pretty much let you have it, I ask you this-Did you really think about what you wrote?

I really hope you pay close attention to all the prescriptions/otc drugs you take, your child(or a child close to you) never accidently gets into medication, and no one your close to tries drugs or has a drug problem. If your idea became a reality-you are screwed and so is everyone else. Something this unethical is not debatable.

I think this may be a time you should step outside your self-centered box.

22

MsLeo: I did not make ANY moral judgements, as far as I can see. I simply asked: is it sensible to restrict the medical caregiven to those who abuse their own bodies (to the point where their own lives are threatened)? Furthermore, let’s suppose that the hospital has a choice, between funding ER care (for drug users) and funding an immunization program for poor children-which would YOU choose to fund?
So please DON’T put words in MY mouth!

23

Nobody ODs on purpose, except suicide. They don’t do it to test the emergency system.
I was on a gurney for an hour at a city hospital once and there were 4 OD’s came in. One was flailing blind and sobbing and peed on the wall, one was in her final month of pregnancy, one suddenly couldn’t move half his body.
They were all hurting bad, and to set them on the doorstep would have been unbelievably cruel.

24

That’s not at all what you said. You only mentioned drugs. If you had menat “those who abuse their own bodies” then you would have said it, but your post implied that drunks in car accidents, bikers not wearing helmets, skateboarders breaking their collar bones, anorexics who starve themselves into a coma, bulemics whose gums are bleeding, and inumerable others are worth more than someone who gets high on a drug that happens to be illegal. All of those problems would fall under “those who abuse their own bodies” by some people’s definitions, not just drugs.

Exactly (though I’d say all drugs not just the ones that can cause overdoses). The problem with the opening post and the whole drug policy in this country is that people do not realize what the drug problem actually is. Most people think of it as a criminal and legal problem, but it’s not. It is a health problem, plain and simple, and not treating overdoses is exactly the kind of thing that makes the problem worse instead of better.

25

Uh, none? I’ve never heard of it happening. Even if it happens occassionally, how many accident victims die because someone with a cold thought they had anthrax and went to the ER? It just doesn’t happen, and even if it does it doesn’t happen enough to actually change the way ERs treat people.

**Why not? What’s this aversion to personal responsibility? **
[/QUOTE]

So if someone makes a mistake, they’re screwed. Eat too much meat, go die. Do a drug that causes you to OD, go die. Hit another car and it’s your fault, go die.

There is a difference between accepting responsibility for an action and paying for that action by dying when there are ways to prevent you from dying.

26

I apologize for putting words in your mouth. I believe you should be a bit more clear.
I am a teacher, a child advocate, someone who has worked immunization drives, and I have seen plenty of the drug world.
I would give the money to the ER, because-believe it or not-there are plenty of ways to get immunizations in this country without paying for them. By saving some “chronic drug user’s” life, you are not taking away from someone else.

27

ralph124c, you have to understand that you’ve posted an offensive point of view, whether you meant to or not. To you, these people may be “drug user 1” and “drug user 2” but to somebody else, they’re “Aaron” or “Cynthia”, or “Son”. These aren’t numbers on a page. These are real people. You are making a moral judgment; you’re saying that some people are less deserving of emergency medical treatment than others. To people who have had loved ones die because they didn’t get this emergency medical treatment, the implication that they weren’t deserving of it is deeply offensive.

As to the immunization question, it’s a false dilemna. Just for the sake of argument, I’ll play along: given a choice between helping somebody who may get sick in the future unless they get help elsewhere and helping somebody who will die right now unless they receive immediate emergency assistance, I’ll unhesitatingly choose the latter.

28

According to EMTALA (The Emergency Medical Treatment and Active Labor Act), hospitals are not allowed to transfer or refuse to treat indigent patients seeking emergency medical treatment.

I’m not sure that this is the exact law that applies to EMS, but we’re not allowed to turn away patients who are seeking emergency care, either.

Also:

So how exactly do you propose that we even find this out? Am I going to have to take a detailed meal and exercise history from a patient before starting ALS care and transport? In addition, what about genetic risk factors for heart disease? Should we not treat all males, since they’re genetically more prone to heart disease?

St. Urho
EMT/Firefighter

29

There is no way doctors could support this. Its would create a huge problem in the relationship between doctors and patients. Once you begin the practice of passing moral judgement on patient prior to deciding whether or not you will treat them, your olbigation as a doctor has been compromised and the quality of the care the patient recieves is in grave danger. Some patients may be infuriating, but a hospital is meant as a sort of safe haven for those in medical need. When someones life is in danger, the first task is to keep them alive. The consequences of their actions can, and should, be dealt with later.

        On the other hand, someone mentioned the cost as a reason why drugs should be legal.  Legalizing a drug doesn't make the problem go away.  Alcohol and tobacco are legal and they are the two most abused drugs in the country and two of the top five killers, in one way or another, in this country.  I am positive that they are the two substances in this country that "cost" the most in terms of how much money is spent on health care as a result of their use and abuse.
30

**So if someone makes a mistake, they’re screwed. Eat too much meat, go die. Do a drug that causes you to OD, go die. Hit another car and it’s your fault, go die.
**

Not at all. I’m just saying TAKE RESPONSIBILITY. That means you pay for it, not others.

31

So, if you’re poor, tough luck? “Sorry, Mr. Pov. You shouldn’t have eaten all of those Twinkies if you couldn’t pay for emergency treatment after a heart-attack.”

32

Who cares? It’s not like anybody held a gun to that stockbroker or schoolteacher’s head and forced them to drive to work. Move 'em over the the shoulder, and let 'em bleed to death.

Exactly. I walk or take the bus to work every day, and I’m sick of subsidizing emergency care for those irresponisble idiots who willfully risk life and limb on the interstate twice a day.

33

So, if you’re poor, tough luck? "Sorry, Mr. Pov. You shouldn’t have eaten all of those Twinkies if you couldn’t pay for emergency treatment after a heart-attack

That’s a lame argument. Should that be extended to everything? No one has a right to the property or services of another.

34

I think education in how to eat healthy is a key factor! Yes, it may be more expensive to eat healthy, but I believe that if we educate people as to why they should fork over more money for healthier foods, the ones who are financially able to do so might just do it.

I say it may be more expensive because of this: when I gave up refined sugar and refined/white grains and potatoes a year ago, my grocery bill went up significantly. OTOH, I very rarely stop for fast food anymore (if I must eat fast food, I can always go with salads and burgers removed from the buns, but it’s tastier to eat at home), and very rarely order pizza (it’s a lot less cost-effective to eat pizza if you can only eat the toppings), so I’m sure the money I used to spend on these things have off-set the cost of the higher market-bill. But let’s assume that it is more expensive to eat healthy. So what? Well-made furniture is more expensive thatn poorly-made. Well-made shoes and clothing costs more. Lots of people are willing to shell out the bux, because they realize that this stuff is worth more. Well, healthy food is worth more, too. This is what we are fueling our bodies with, folks. What’s more valuable than that?

Also, education can go a long way towards alleviating the “time factor fear” involved with doing your own cooking. My microwave, George Forman grill and crock pot are all spectacularly helpful. As is meal planning. I take an hour each week to plan my meals. This way, I can use my markets’ sale paper to take advantage of what’s on sale. Also, I can look at my schedule, and see that, Tuesday, for example, is really busy. So, I’d better plan a crock pot meal for that day. That way, I can put it on to cook in the morning, and serve a hot, healthful dinner in almost no time at dinner time. Also, planning ahead allows me to cook doubles of some recipes (things like stews, spaghetti sauce and meatloaf, it’s just as easy to make double and freeze half), so on really, really busy days, all I have to do is take something pre-cooked out of the freezer and microwave it. But a lot of folks just don’t know how to do this stuff. They’re not dumb, just uneducated.

I realize that for the very poor, some of this might not be realistic, but for the average person, I think it is. It’s just a matter of education.

As for exercise, I’m more likely to do it if I’ve scheduled it. If I wait until I have time, I never have time. Richard Simmons videos (if he doesn’t drive you nuts) are great family exercise, cuz the kids love to dance along, and they consider it “time spent with mom”.

35

Oh, boy. I just posted to the entirely wrong thread! Duh! I was just reading a thread in GD about solving the obesity epidemic, and just composed the above post for that thread.

Please excuse the stupidity, folks.

36

And you would define “abusing their own bodies” as what?

Soccer players who, as a group, incur high rates of ACL and PCL injuries? Why should we pay just because parents want little Johnnie or Susie to participate in athletic activities?

Runners who have disproportionately high rates of achilles tendonitis? Do they really need to be running, especially after the age of 35? It’s not just exercise – it’s an addiction. And not healthy for our pocketbooks.

Construction workers with back injuries? They could have chosen a different line of work instead of building the places where you live and work, and the infrastructure that allows you to get from one point to another. That physical labor’s going to add up to some expense at some time.

Roofers who fall off ladders or roofs? Again, they don’t HAVE to do those jobs. Let everyone fix their own roofs.

Skiiers with broken bones or hypothermia? It’s their choice to ski for recreation and fitness. Why should we have to pay for it?

Hunters who accidentally shoot themselves? Or someone else? They don’t need to be preying on dumb animals, let alone using firearms.

People who are allergic to bee stings? They could move to, like, the tundra where there’s not much chance of encountering those critters. Being out of doors is not a necessity. It’s selfish of them and financially draining to the rest of us.

Women with gestational diabetes or eclampsia? After all, they took on these risks when they got pregnant. They should have known that it could have happened.

People who have herpes? That’s self explanatory. What’s up with all the sex stuff? Sin here, sin there, sin everywhere.

Women who think it’s alluring to wear corsets and squish their internal organs? Mo’ money.

Asthmatics who live in smog prone areas? Let 'em move.

People who build on flood plains? In places that have high wildfire risks? Earthquakes? Tornados?

Sunworshippers who develop skin cancer? Swimmers/divers who drown?
To have a meaningful discussion of the issue the parameters must be defined. Is it just the recreational drug user who’s exempt from the insurance? What about all the other non-essential things that people do that can incur illness or injury as a result? And, what is non-essential?

37

I don’t think it is. In this country we have decided that, yes, you do have a right to life-saving emergency care, even if you cannot pay for it.

I disagree with your notion of “personal responsibility” in this case. After all, you don’t know if that fat man who had a heart-attack has a glandular problem, rather than just being a glutton.

Even if he is a glutton who has damaged his body through irresponsible eating, so what? It’s not for doctors to pass moral judgements on their patients.

Imagine if doctors who dissaprove of the gay lifestyle chose not to treat AIDS patients. (What about those who contracted it through other ways than gay sex?) Imagine if cardiologists refused to treat patients who didn’t excersise properly. (What about those with joint problems?) Imagine if oncologists refused to treat lung cancer patients? (What about those who contracted it through second-hand smoke, or exposure to chemicals?) What if doctors refused to treat drug ODs? (What if the patient accidently took too much prescription medication?)

My point is that in a life-or-death situation, a doctor doesn’t have the time (or the right, for that matter) to sit down, study the patient’s lifestyle, and determine whether or not they are “worthy” of treatment.

I also see it as cold and heartless in such a wealthy country to say to the poor, “Pay or die.” I’m happy to pay taxes for services such as these. There, but for the grace of God, go I.

38

**I don’t think it is. In this country we have decided that, yes, you do have a right to life-saving emergency care, even if you cannot pay for it.
**

Not exactly. Under current circumstances, we do treat those cases, and despite my rhetoric I do support that policy. But let’s be clear. It is a matter of law, not a right. At any time it can be changed by simple majority votes. Rights don’t create obligations on others. If circumstances ever do seriously require us to prioritize, ODs that can’t pay will be untreated. Since this is not currently the case, as has been pointed out to me, the current law works great. But if we establish that an OD has an equal RIGHT to care, that everyone has a right to care regardless of their circumstances, then we create a very bad situation. When you carelessly establish rights that create obligations on others, who is responsible when a person’s “right” to care is not met?

I also see it as cold and heartless in such a wealthy country to say to the poor, “Pay or die.” I’m happy to pay taxes for services such as these. There, but for the grace of God, go I.

I see that the right has no monopoly on imposing their personal moral values on others.

39

adaher: Rights don’t create obligations on others.

Huh? Of course they do. It restricts and molds behaviour that would otherwise be more uninhibited.

40

Then let me clarify. You cannot have a right to something that someone else has to provide. One obvious reason is that there will not always be someone to provide the service or the good, or the good or service simply won’t be available. If you establish that everyone has a right to good or service A, but there is only enough of good or service A to provide it to half the people that need it, then you have the absurd situation of people’s rights being violated. Who is responsible? You also invite authoritarian intervention by the government, who now has to play God and decide who gets what.

When supplies are more than plentiful to provide to everyone, then as a matter of temporary law it could be considered advantageous and socially just to make sure everyone can get it. But it should be recognized that this is an act of public charity, not a right or an entitlement. It should also be recognized that it would be subject to change.