Are we seeing a version of Milgram's experiment play out on patients because "experts," who never treat physical injuries or illnesses, told our government that it's almost never appropriate to relieve pain with medicine? Do we blindly follow "experts"?
Do we blindly follow them even when they provide absolutely no scientific evidence? All signs point to yes. We saw addiction psychiatrists with fringe views attempt to convince the FDA to implement dosage caps for medicines but they failed to provide evidence & were refused.
It appears they were attempting to use a government agency to implement a policy that wasn't supported by evidence. The group didn't give up. They subsequently got involved with a CDC workgroup on the development of a "guideline" for prescribing pain medicines.
Since the "guidelines'" incorrect application across the board (instead of just for primary care practice), many patients were abruptly removed from the medications keeping them stable. I was one of those patients. I nearly died as a result. Some were even less lucky than I was.
A mountain of anecdotal evidence suggests many who were forced off of their medications subsequently died from heart attacks, strokes, and suicides. But we don't know the true number because no one bothered to track outcomes of this public health intervention.
This intervention was not only unscientific but it also never should have affected patients outside of the primary care setting, nor should such "guidelines" have been codified via federal law enforcement targeting of "high prescribers."
There is more to cite but this medium makes it difficult. The principle of social proof was used by zealots who appear to have been trying to increase their customer base by claiming patients on pain medicine were really "addicts," even though addiction rates have not changed.
What is the ethical response in this situation? It used to be to allow licensed physicians to make the call based on individual cases. This is no longer possible now that clinical decision "support" & predictive analytics are employed to alter physician/provider behavior.
Discrimination against patients based on immutable characteristics and histories (e.g. history of sexual abuse) & the infantilizing of doctors is now common. We now see structural barriers to one of the most empirically supported pain relief modalities known to man.
How'd we get here? Through "expert" advice that became de facto law. Pain is inflicted on one of the largest patient demographics through a structural barrier erected "for their own good." It doesn't allow for physician autonomy. In fact, the barrier further restricts it.
“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. ... those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.” ― C. S. Lewis
Many people have died. Many more have lost their ability to participate in life. Figures could be in the tens of millions. We don't know because no one bothered to ensure a framework existed for tracking outcomes of forced public health interventions.
@threadreaderapp unroll, please.
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