Wednesday, January 30, 2013

Do No Harm and Risk Verses Benefit Medicine

The first concept in medicine is to do no harm.  This means that no medical treatment should do any harm.  While this is ideal, there are always risks.  There is a risk associated with making a decision just as there is a risk of being indecisive. 

Another medical concept is risk verses benefit.  This means that a treatment or diagnostic procedure may give positive results but there is “xyz” risk associated with it.  In most cases full risks are not disclosed.  A risk verses benefit is of course a direct violation of the do no harm concept.  Since no one can foresee the future, there is no science in the risk/benefit concept.

There are times that there may be no choice in a decision.  This may include non-elective surgery.  Any surgery carries a risk.  There is also risk associated with getting pregnant or driving a car.  Risk is part of our daily lives but we would hope that a medical treatment is risk free carrying the benefit of wellness.

A study from the National Cancer Institute estimated there would be about 29,000 future cancers from CT scans done in 2007 alone.  Which individual would have guessed there is a risk or getting cancer from the radiation from a CT scan?  Proponents say in spite of this the CT scan has saved lives.  The question would be which ones? 

I have not seen any mention of cancers caused by mammography.  It has always bothered me that this diagnostic medical procedure causes the disease they are looking for.  (Please see the Breast Health Blog.)

So when is it all right for a medical treatment or diagnostic procedure to cause a disease?  Medical decisions are choices that often require common sense and a clear head.

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