Cell 2 Soul: The Humane Health Care Blog

Dax Cowart (1947 - 2019)

Full NY Times Obituary.

In 1973, Dax Cowart sustained debilitating injuries from a propane gas explosion that resulted in the loss of his hands and eyes. After his immolation, Dax became a lawyer and a prominent patients’ rights advocate. In the face of what he saw as medical paternalism, he argued that patients should have more autonomy over what treatments they receive and a choice in whether they even receive any treatment at all.

He overcame his hopelessness and found a mission in trying to persuade doctors to demonstrate greater respect for their patients’ wishes.  Cowart articulated his ideas in a powerfully positive way, and influenced many young doctors in their approach to patient care.

“To make this clear,” he added, “if the same thing were to occur to me tomorrow, and knowing that I could reach this point, I would still not want to be forced to undergo the pain and agony that I had to undergo to be alive now. I would want that choice to lie entirely with myself and no others.”

Not that you have time; but here is the Dax Cowart Documentary (1 hr).

Don't Demonize Opioids

Our preoccupation with opioid misuse could become the tail wagging the dog
Bob Roehr biomedical journalist. Washington, DC, USA
BMJ 2017;359:j4727

It is rare that we hear from those who use prescription opioids on a chronic basis. Their voices are important counterpoints to the loud, self-righteous jeremiads of physicians, politicians and law enforcement professionals.

Roehr tells us:

• Demonising prescription opioids can come to no good end.
• I use an opioid drug, hydrocodone, every six hours, and have done so for about a decade.
• The surge in opioid related deaths in the US is troubling. But it is important to remember that it is fueled by street drugs and by fentanyl and its analogues, either alone or laced into a variety of illicit drugs.
• People who have lost access to prescription opioids have turned to cheaper, more accessible, and more dangerous, potent black market options, according to experts, and the death toll has soared.

Full BMJ article: Download Roehr Don't Demonize Opioids

The Pain Hustlers

by Evan Hughes

Most physicians know how they are used by PhRMA to write prescriptions for costly new drugs. From an in-depth article in the Times Sunday Magazine of May 6, 2018, we learn about an outlier company and how it marketed a new expensive pain medication, Subsy. Many drug companies promote their products in similar ways but this company, Insys Therapeutics, took the tactics to a crazy, criminal extreme. I checked on the website GoodRx and found the monthly cost of Subsys to be about $24,000!

You can read some excerpts here: Download The Pain Hustlers by Evan Hughes edt

Dr. John Kapoor became a billionaire from SubsysFull NY Times article.

Physicians on the Take

Recently, payments to your physicians by PHRMA and device makers have been made public. That's good news. The bad news is that it is damnably difficult to access this information. There appear to be many firewalls. Suffice it to say, many physicians in the US are on the take. It may even be worse in Canada. It must be the same everywhere expensive drugs and treatments are utilized.

Here are links to the recent New York Times articles about this new database.
1.  What We’re Learning About Drug Company Payments to Doctors, September 30, 2014
2. Detailing financial links of doctors and drugmakers, October 1, 2014

I found the government site difficult to navigate.
However, the Dollars for Docs web site was much simpler and gives similar information.

These sites probably underreport payments, but they still have meaningful information.

Ladder of Sorrow

My Mother-in-Law’s One High Day

When my mother-in-law was in the final, harrowing throes of pancreatic cancer, she had only one good day, and that was the day she smoked pot.  Read this thoughtful, sad piece from the NY Times Journal of Medicine (12/10/11).