Every time I go to see my oncologist for my monthly white blood cell transfusion, I reflect on the time and effort that my doctors put in on my behalf so that I could survive my difficult battle with multiple myeloma in 2009.
Thankfully, I responded very well to an innovative pill-based chemotherapy regimen and was able to have an autologous stem cell transplant later that year. I also dealt as well as one could with the horrid side effects of cytoxan and melphalan that one faces during this pre-transplant process. I have been taking a maintenance dosage of my pill chemo for four years, and I have not registered any perceptible signs of the cancer since coming home after the transplant. And, more importantly, I have no limits on what I can do -- for the last five years I have exercised, taught at three different colleges and enjoyed a full life with my family, friends, co-workers and students.
Despite this extremely successful course of treatment, some medical bureaucrats seem to think that I am an outlier -- a mere statistical oddity who was not economically worthy of receiving this level of care. These soulless administrators endorse Quality Adjusted Life Years (QALY) restrictions that will cause thousands of people like me that show up at hospitals with life-threatening but treatable illnesses to be denied medically justifiable care and potentially thwart the development process of new and better medications.
At the time that I was treated, most multiple myeloma patients were dying in one to three years. In the United Kingdom -- the home of QALY care -- my treatment protocol had not yet been approved under their national health plan due to cost concerns and the statistical likelihood of its limited extension of life. If these rules had been in effect in early 2009, I would probably not have survived -- and those that endorsed these theories would have surely been complicit in my premature death from cancer.
In order to implement their questionable QALY goals, they support changes in the Hippocratic Oath to force doctors to balance treatment of their patients against some vague and ill-defined notion of costs to society at large. In the process of implementing these changes, patient and doctor choice will be restricted to the detriment of all patients. It will also surely shred the trust patients place in their physicians to make sound, scientifically-supported medical decisions as opposed to viewing the patient as a cost or burden to the system.
The Hippocratic Oath that they want to alter is not just a vow taken by doctors, it is also a moral statement and implied contract between the patient and all members of the medical profession. Every time I receive care I think about what it means, how it affects me and how it has encouraged better results and advanced cutting edge treatments.
Two items in this oath resonate with me as a patient and cannot ever be amended without affecting my care and the care of others. The first one is "that I will recognize the limits of my knowledge and pursue lifelong learning to better care for the sick and to prevent illness." In other words, doctors are mandated to embrace continuing education and innovation as an integral part of their profession. They are required to seek new methods to treat their patients and educate themselves regarding new medical care -- new medical devices, new medicines, new methods of surgery. My doctors did this -- and their intellectual curiosity and forward thinking probably saved my life!
The second one is "that I will not withdraw from my patients in their time of need." A doctor is bound by this sacred and historic oath to treat the patient in front of them to the best of their ability and not shirk this duty in any way. They are not supposed to think about any imaginary or amorphous patient that might walk through the door into their office -- their duty is to the patient as person in front of them at that moment in time. My doctors were there with me when I needed them, working as hard as I did to fight the cancer.
By extending the Hippocratic Oath's meaning to the society at large and acting as unlicensed accountants as opposed to the board licensed physicians that they are, officials are effectively endorsing the rationing of medical care, opening up numerous moral and ethical issues as to how care is provided, creating professional conflicts and completely removing the trust people place in their doctors.
Who do you trust with your life? A doctor that is bound by a sacred oath to serve the needs of their patient or a medical or government bureaucrat with limited financial knowledge who has never met you and wants to restrict care and save money, perhaps at the premature "cost" of your life -- or that of your father, mother, husband, wife, children or friends?
As for me, my experience tells me that I will only place my trust in a medical professional when they don their white coat -- not a green eye shade.
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