People increasingly use the internet to explore medical issues. That is in general a good thing, provided they are careful about using credible sources for their information and are not too credulous about what they find. Being more knowledgeable about their own health can make for more fruitful conversations with their physicians.
But the old saying ‘a little knowledge is a dangerous thing’ can sometimes kick in and people can decide that they know more than their physician, or indeed the entire medical profession, and demand specific treatments. They especially do this when it comes to ‘off-label’ uses of drugs, when people ask that a drug that has been shown to be effective in treating one condition be used to treat a different condition where its efficacy or even safety has not been established. People sometimes seize upon anecdotes about its use to demand that it be prescribed for them.
This often puts doctors in an awkward spot. If they feel that the drug should not be prescribed and refuse to do so, they may face angry patients. Many refuse to compromise their ethics but now people are actually going to courts to try and get judges to order that the treatments be given, in this case with the animal de-worming drug Ivermectin. And some judges seem willing to do so.
At least two dozen lawsuits have been filed around the U.S., many in recent weeks, by people seeking to force hospitals to give their COVID-stricken loved ones ivermectin, a drug for parasites that has been promoted by conservative commentators as a treatment despite a lack of conclusive evidence that it helps people with the virus.
The lawsuits, several of them filed by the same western New York lawyer, cover similar ground. The families have gotten prescriptions for ivermectin, but hospitals have refused to use it on their loved ones, who are often on ventilators and facing death.
There has been a mix of results in state courts. Some judges have refused to order hospitals to give ivermectin. Others have ordered medical providers to give the medication, despite concerns it could be harmful.
Some lawyers have seized upon the fears of patients to file lawsuits demanding that ivermectin be given. Medical ethicists are appalled at this development.
Hospitals have pushed back, saying their standards of care don’t allow them to give patients a drug that hasn’t been approved for COVID and could potentially cause harm, and that allowing laypeople and judges to overrule medical professionals is a dangerous road to go down.
“The way medicine works is, they are the experts, the doctors and … the hospitals,” said Arthur Caplan, professor of bioethics at New York University’s Grossman School of Medicine. “When you go there, you’re not going to a restaurant. You don’t order your own treatments.”
“You can’t have a medical field that’s subjected to having to practice according to patient demand backed up by court orders. That is positively horrible medicine” Caplan said.
Beck, the drug liability lawyer, said that doctors do have the power to prescribe ivermectin to treat COVID, even though it hasn’t been approved by the FDA for that disease, if they think it has therapeutic value — a so-called “off label” use.
“I have never seen a case before this where the judge was asked to force someone to engage in an off label use,” he said.
While the law does intrude into every area of life, judges should not think that it gives them carte blanche to impose their judgments in every area. For example, on academic matters, students have sometimes sued professors over their grades but judges have tended to defer judgments about academic performance to the professors, since only their have the required expertise, intervening only when professors have acted capriciously and in violation of academic norms. That same principle should hold when it comes to medicine too. Judges invading the professional space of physicians and overturning their judgments is a dangerous trend.