Medical Negligence and Malpractice - Essay Example

?Introduction In a world where every business wants to ensure increasing sales and does not hesitate to sometimes even use illegal means of achievingthis target, the same practice of keeping a focus on just earning money is replicated in the profession of medicine. This paper will discuss the issue related to how pharmaceuticals have gone stray from their focus of preventing from diseases to a money making business. It will also discuss tactics deployed by some companies, such as; creating fear of new diseases, releasing untested drugs, testing their drugs in poorer countries, prescribing medicines meant for adults to children and infants, prescribing medicines to chronic patients which have not been tested for long term usage, imported drugs and many others. Personal cases of medical professionals will also be discussed where they reveal the true face of pharmaceutical industry in addition to the existing laws against such practice. Finally suggestions and recommendations will be made to effectively handle such problems. According to the Canadian Bar Association (2010), Medical professionals are under strict legal binding to provide their patients with the best care and treatment possible. Rule no. 3A of Medical Duty states that it is a duty of any medical professional as he/she legally owes proper care to the patient (Khan, et al 2002, p.71). They may completely refuse to undertake any given case due to any reason, personal or other. Once they accept any patient, they are bound to providing proper medical treatment. As Keir et al (2007, p.33), providing detailed and the best possible care to their patients is what actually constitutes proper and efficient practice of medicine. If in case the professional fails to deliver the kind of service that would be given in any normal circumstances then it is referred to as Medical Negligence (Barnes, 2001, p.113). In such a case, if the patient suffers an injury due to the doctor’s negligence of medical professional, then the patient reserves the right to sue the medical professional against medical malpractice (Bardale 2011, p.23) In the recent times of capitalism, pharmacies are also not left behind in the rat race of increasing profits (Gad, 2009, 04). Following table gives the evidence Table: Top 25 Drug Companies by Sale (2006) According to Rat h (2003, p.50), pharmaceutical industry is now striving to driving its forces to increase the sale of its product rather than achieving its main motive of curing the diseases in the world. The ultimate aim to innovate new medicines is only to relieve symptoms of any disease, not to eradicate it. Eradicating and eliminating any disease through thoughtful research in the field of medicine would mean destroying the chance to earn millions of dollars in form of prescriptions. For this purpose, new breakthrough and advancement in the field of curing any disease are suppressed and do not get the kind of attention it deserves. This suppression is the reason why many fatal diseases are still incurable. In order to boost sales, pharmaceutical companies are deliberately holding back information which the public has every right to know like the common side effects and risks to other organs of the body.(Company, 2002, p. 326) The real face of drug companies (Luisa, 2011) shares the experiences of Gwen Olsen, who used to belong the same industry. Gwen states the frightening and alarming truth about this industry which has become extremely corrupt, running only after the financial gain rather than medicating its patients. Olsen (2009, p. 09) even states that as a Medical Sales Representative, she was trained by the company to give misinformation to doctors and medical professionals about the medicines her company produced. It has just become a game of money where disease seasons are awaited and KPIs matter more than empathy towards curing their patients. Agell (2004) talks about her personal experience with the viciousness of pharmaceutical industry. She had the honor of spending about twenty years of her life for “Journal of Medicine” in New England. During her tenure, she saw the drug companies wander off from their main mission that is to discover and eradicate world diseases and focus all of their energies into getting the sales up, consequently becoming money minting machines. Agell also saw firsthand how these companies were influencing education and research, even doctor, instructing them how to treat their patients and how much research to do which would restrict the treatment of any disease to managing symptoms rather than eradicating. Dr. Angell argues over the amount of money spent on healthcare each year. Every new drug introduced as a best sellers carries with itself 3 factors according to the personal experiences of Avorn (2005, p. 30). These factors are more powerful effects, powerful side effects and an escalating price of drugs. He adds that using these medicines is a subtle compromise between these three factors. Disease Mongering Some drugs companies even go as far as creating false fear of many diseases in order to increase their sales (Wallechinsky, 2011). This creation of fear and the thought of people suffering dangerous disease is known as “Disease Mongering” Payer (1992, p.10) talk about many of the tactics used by medical professionals to create the fear of disease. 1. Take any normal function to imply that patient is suffering from a dangerous disease and needs to be treated for the said disease. Not surprisingly, this treatment will take quite a long time to take effect. 2. Focus on a very common symptom, which in many cases will refer to anything; maybe even a common cold and pronounce is such that it may be a symptom of a fatal disease. 3. Reiterating the fact that the patient might be suffering from a dangerous disease by suggesting that a lot of people has this disease. 4. Recruit doctors in spreading this news 5. Used medical jargon when addressing the basis for this disease. Pharmaceutical companies also induce tactics to increase the sales by; promoting those drugs which address problems and issues which were previously never considered even medical problems, for eg. Disruptive classroom behavior; anxiety in healthy patients thinking about what health problems they might be suffering in the future or making up new diseases which are difficult to differentiate from normal everyday behavior. All of the above requires a lot of creative as well as aggressive marketing to convince people that they are indeed sick and in need of medication and treatment. As stated by Greenberg (2010, p. 225), one of the latest fads created by these drug companies is extreme advertisement of depression. The term depression has gone out of the window and the new term “Attention Deficit Hyperactivity Disorder” or ADHD as it if commonly referred to. Cooper (2005, p. 122) discusses the aggressive marketing strategies that are used to make people aware of this disease which seems to have taken over everyone like a storm. Advertisement strategies even include a special days for these kind of disorders, known as “World Mental Health Day”. The drugs prescribed for treatment of this disorder are so high potency that effectively controlling their side effects transforms into another disease. Yapko(2009, p.06) comments on how the marketing is targeted towards all age groups with varying kind of potencies. Another case highlighting the same issue of creating diseases out of ordinary everyday symptoms is discussed by Moynihan and Cassels(2006, p. 50). The target case of this study was Henry Gadsen who was heading Merck, a multi-million dollar pharmaceutical company. Gadsen wanted to targeted normal, ordinary and healthy people for treatment of his created diseases. He wanted Merck to be like Wrigleys, being able to reach out to everyone. He forgot any important ethical factor that medicines and drugs are given to patients suffering from a disease. It has become a common practice to pop pills in the mouth like toffees or gum, but that certainly does not make it a correct practice. Mild symptoms and problems are now defined as big and dangerous issues that need to be urgently and immediately looked into. According to this strategy of targeting and selling medicines to everyone, the scope of pharma companies kept on broadening and they were successful in stretching the boundaries of illness and diseases. Edlin and Golanty(2009, 369) state that doctors are resorting to prescribe medicines for mild everyday problems which are basically just situational problems like headaches and gas. Everyday drugs Ordinary and health people are getting engulfed by this fear that they are suffering from some dangerous disease. Hanson et al.(2006, p.36) illustrate how drugs are being abused by ordinary people as they are getting hooked to the use of drugs. Many people lose their ability to solve their problems themselves and resort to using strong drugs. They expect the drugs to solve their problems but fail to realize that drugs will just take care of their symptoms, not the problem itself. Use of drug is quickly turning into abuse of these drugs. Grave reality Another sinister factor which needs to be addressed has been handled by Shah (2007, p.11). The author states from her personal experience that these drug companies are testing their medicines on people like it is done on rats. The pharmaceutical companies are advertising loudly about their latest new drug which is more powerful than the older versions but no one questions them on who are the guinea pigs for testing these new medicines. Drug companies more often then not test their new products amongst the poorest and the least powerful of all. This is why they never report where these medicines are tested and it gets burrowed underground. Many big names in the pharma industry are already conducting about 30- 50 percent of their medicines in countries outside of their jurisdiction, generally targeting poor countries(Jamison, 2006, 611). Companies are even resorting to misrepresenting the data to get rid of the malpractice issues arising out of this practice.(Abramson, 2005, p.68) Medela (2012) states, a staggering 2/3rd of the medicine available in the market have been untested for their effects on breastfeeding and lactating women. On top of the fact stated above, drug companies are also releasing and vigorously marketing products which are not even tested properly. According to Stolley(1993, p.01), in serious diseases, activist demands for new therapies and drugs. In their haste, drugs get rushed to the market before getting their efficacy, safety and quality checked. As far as it comes out of compassion, it may prove to be of value in patient otherwise already pronounced clinically dead. But if the same case is repeated for not so fatal and curable diseases, then it is negligence on part of drug companies. Similarly Washington (2012, www.cnn.com) conducted a research which found shocking results indicating that doctors were even prescribing some medicines which were not just tested poorly but they were not getting tested at all. The drugs are actually getting tested on patients without them not even realizing. Worst of all, these patients are none other our own children. Many a times, the drugs approved by Food and Drug Association, for use in adults are being tested for effectiveness on children. This means that for the doctor’s part in prescribing correct dosage, it’s best a guesswork. Every child reacts differently to every medication. Experimenting these medications on children can prove devastating due to the side effects associated with them. They may lead even lead to fatal and dangerous syndromes. And let’s not even go into the details of what damage the imported drugs are causing all around, drugs which are far from getting testing or submitting any reports whatsoever (FDA, 2011). Example of Cases There are numerous cases in which taking untested drugs lead to future problems whether it was noticed in adults or children; some of the examples are mentioned below: A drug for averting morning sickness in pregnant women called thalidomide (Neisman, 2009) has been found causing birth defects in fetus of the unborn babies. True, the drug was effective in advertising this nausea and morning sickness but it also lead to birth defects, in addition to many other side effects like pneumonia, edema, blood clots etc. while the pharmaceutical company collects increased sale of drugs. Once again, vaccines of swine flu are getting tested on pregnant without prior knowledge of what side effects are associated with it. The principle of making the swine flu into a deadly disease is a theory created by all the authorities involved and is part of the negligence and malpractice (A dangerous Medical Myth, undated). Another case which involved a well known drug company forcing many doctors into prescribing a drug for use in patients suffering from symptoms other than the principle disease for which the medicine was regulated. AstraZeneca, UK’s well known pharmaceutical company was found to be involved in increasing sale of their drug, Seroquel, which was tested for treatment in psychiatric patients (Foley, 2009). A list of unsafe drugs is available for viewing on http://porphbook.tripod.com Furthermore, many a times drugs get prescribed to patients but the long term effects of using those drugs are not known (Nesmith, 2005). This is a grave problem in this case where medicine prescribed to treat chronic insomnia and assumed that it can safely used for long term. In addition to that, for treatment of insomnia, doctors are prescribing antidepressant without checking for any relations between the insomnia and depression. Pharmaceutical Negligence and Malpractice in UK All the above is part of what cause pharmaceutical malpractice and negligence. According to Attorneys Trial Group (http://www.attorneystrialgroup.com), pharmaceutical malpractice is when a drug company or a pharmaceutical company causes damage or death to their consumers. Basically it means that the drug company was negligent in providing their consumer with proper care that was required. Ethically speaking, this may be because of any of the reasons stated above, but legally it can be called a case of malpractice this may be due to drugs not getting properly testing as stated by its standard testing procedure or if the drugs are released before time. Furthermore, it will be considered a case of negligence and malpractice on part of the pharmacy if the sales representative fails to provide the doctor proper warnings and effects of using the drugs. In the United Kingdom, laws against case of medical negligence and malpractice (Medical Negligence UK), in laymen terms states that if a physician is responsible for any injury or death to a patient, then they can sue within 3 years of the occurrence of this event (Giesen, 1988, p.488). This time limit may be over ridden as it is on the court’s discretion. As far as laws against pharmaceutical malpractice are concerned, UK calls it laws against product liability. Most of the laws are against incorrect dosage provided by Drug Company or defective drugs (Grubb et al., 2011, p. 972). Even though many laws exist against pharmaceutical companies, there are very few cases that are reported. Many a times the side effects associated with drugs are not reported and patients suffer due to that; still it is considered part of the deal when using high potency drugs that consumers never think about suing pharmaceutical companies. It is a shame that many of the laws against drug companies, fail to realize what these big giants are doing to the world. It is completely ignoring the fact that many of these medicines didn’t even needed to be invented in the first place and are getting used like candy. Cases in UK involved in Pharmaceutical Negligence and Malpractice Huff (2011) narrates a case highlighting the issue where big names in the pharmaceutical industry markets drugs without properly testing the side effects. It is a case of Lucy Hink, a 13 year old, above average student, who turned into a vegetable when she took her 3rd dose of Cervarix, a vaccine to treat HPV, human papillomavirus. This drug was produced by a very popular pharmaceutical, GlaxoSmithKline, which was responsible for turning a healthy girl comatose state, sleeping almost 23 hours a day and in constant need of attention and care. She took her doses in accordance to UK’s Health Department which started a campaign to vaccinate all school going girls against this disease. All girls were subjected to this vaccination, unless the parents specifically opt out of it. The parents showed concern of the side effects for this vaccination who were reassured that problems are not probable. Another vaccine used to treat the same disease is of 21 year old Brittany, who was prescribed the vaccine Gardasil after she was involved in a college lab accident. Soon after the vaccination, symptoms started showing which may be called Post-Gardasil syndrome. She soon lost strength in her legs and has still not recovered from her condition (Mathis 2011). In another case, a UK based family won a case when their son started experiencing unknown side effects which included arthritis, epilepsy, Crohn’s disease etc. These symptoms were reported after getting the MMR vaccination produced jointly by GlaxoSmithKline, Merck and Aventis Pasteur. The patients’ families were granted financial aid to pursue their case of suing the companies which they eventually won. Reportedly, more than a hundred families were known to have noticed side effects after the 3 jabs of MMR vaccine (Doward 2004). Another pharmaceutical had to bend down in front of the law for copying a brand. This fight was between Pfizer and Teva over their brand Lipitor, a cholesterol fighting drug. Teva will reportedly call off their version of the drug till the 2012. UK witnessed a fierce battle between the two companies (Staton 2011). Roche Pharmaceutical, another big name in the pharmaceutical industry, was found guilty of being involved in over-marketing a product when the total side effects were not known. The controversial drug was Accutane which was recalled from the market because of its harmful effects. Apparently, the company was aware of these problems when they were launching this drug. 27 years after the drug was launched, Roche had to recall them as they were causing serious birth defects (Westbrook 2011). The Express (19 April, 2009) reports on a case of British teenagers who sued a pharmaceutical company for a drug manufactured for treatment of cervical cancer known as Cervarix. Many parents suspected that this vaccine would cause problems but a few amongst the girls receiving the jab suffered severe side effects of paralysis, etc. Many physicians also reported that this vaccine had been introduced in the market far too soon for vigorous testing to take place. Problem at hand The recent problem at hand can be seen by asking in two questions. Why the drug companies are not conducting enough tests or not testing their drugs at all. Furthermore, why are pediatricians prescribing medicines to children that have only been tested for effectiveness in adults? This is because conducting tests and clinical trials cost money; Fernando (2009, p. 2.25) states “more than 40 per cent of drug development costs are incurred in clinical trials”. Furthermore, it is negligence on part of the pediatricians who are doing guesswork when prescribing adult medicines to children. Solution and Recommendations Testing drugs on self bred animals The law requires drug companies to test their medicines properly on animals which are bred only by license holders for the purpose of their medical research (Pro-test.org.uk). The type of animals that can be used for such medical experimentation are mice, rats, fishes, birds, sheep, rodents, small mammals, dogs, cats and monkeys. No pets or unwanted animals may be used for such experimentations; this is strictly against the law. Let alone humans, using guinea pigs without prior permission is out of the question. Law even suggests the number of times a single animal can be used different experimentations (British Medical Association 1994). Crack down of untested medicines As required by the law, companies should submit drug testing reports to authorities. The authorities should not just wait for the reports, rather conducts raids if they doubt on the intentions of drug companies. For example the case listed by The Associated Press (2011) where FDA cracked down many of the untested allergy medicines. Authorities should keep a strict check on the number of test reports sent for approval and number of drugs releases every year by every single licensed pharmaceutical company. Furthermore, the authorities should remain vigilant when a particular drug just released in the market has suddenly skyrocketed in terms of their sales. Mystery shoppers could be sent at clinics and pharmacies to ensure that these drugs are being prescribed to patients who are meant to use them. Finally, in case the drug companies are found to be caught red handed, the news should be advertised in form of press releases as well heavy fined should be imposed. The bigger a company’s name is, the higher the fine should be. This would ensure that other companies learn not to repeat such activities. Prescribing medicines only to patients for which it is proven effective Many of the medicines get approved for use and effectiveness in adults so they are through from the authorities head, but Hill’s (2005, pp. 17-18) study suggest that physicians should fear getting sued if adults prescription drugs are getting prescribed to children. In many cases, these drugs are being prescribed even to infants. In such cases, it is not only the drug companies at fault, it is also a duty of the physicians to check for dosage and age requirements before agreeing to prescribe these medicines. Ultimately, vigilance is required as it is literally a matter of life and death. References Abramson, J 2005, Overdosed America, HarperCollins, New York. A dangerous Medical Myth (undated), viewed 9 May, 2012, http://pregnancy.baby-gaga.com/articles/medical-myths Angell, M 2004, The truth about the drug companies, Random House, New York. 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