A Doctor Asks, “Who Am I?” Part 3

By | July 30, 2011

Who is responsible for rare but life threatening complications of appropriate therapy, like this man with Stevens Johnson Syndrome?

In yesterday’s bloc we spoke about the divergent opinions of European Colonists and Native Americans with respect to personal responsibility. This divergence of opinion exists in our society as well, but in a much more restricted form. Our courts generally make the distinction between an interaction between equals and those in which one party is felt to have special knowledge or authority. An obvious example would be the responsibility of a physician prescribing medicine for a patient. Even in a case as simple as prescribing an prescribing an antibiotic for a person with the signs and symptoms of bronchitis, a physician would be held liable for explaining all of the benefits as well all of the major side effects or potential complications of a medication and monitoring the patient for adverse reactions. In the case of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis, a rare and potentially fatal skin disease that can occur due to antibiotic hypersensitivity, I know of cases where a physician has been sued, unsuccessfully but sued nevertheless, for having correctly prescribed the antibiotic, even though they diagnosed the complication in a timely manor and treated it successfully. While all of us know that sharing prescription medication is wrong I doubt that any court in the country would hold one friend responsible any adverse events that occurred after sharing a prescription for the same antibiotic. Furthermore, given that all knowledge especially that concerning possible future events is uncertain, at what point does the patient become responsible for his acceptance of therapy. These issues become all the more concerning when dealing with antidepressants and other psychotropic medication as in the setting of chronic pain.

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