Central PA Medicine Spring 2018 - 21

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p front, I have to be honest that I looked up that word. Eschew. It's
a synonym for "avoid" or "steer clear of."  I like the way it sounds.
But its meaning is clear and unambiguous.  Several times a week,
when I review in depth the terms of an advocacy agreement with a
new PHP participant, I will advise them to eschew prescribing all drugs
for themselves and for their family. This is one of the things participants
must agree to and sign. Intuitively, I understand why physicians who
may be addicted to mood-altering drugs should avoid self-prescribing,
because they hold the key to the candy store. And as a surgeon, I understand the admonition against operating on a member of my immediate
family; would I have the emotional self-control to successfully deal with a
life-threatening complication, such as a major hemorrhage, if the person
laying on the operating room table before me was my wife or my child?
The need to avoid that scenario is easily understood.
But then I began to consider further what I was requesting of the participant. Why avoid prescribing for family? What's wrong with prescribing
a Z-Pak for your teenage child with bronchitis? What do medical ethics
say about this practice?
The very first code of medical ethics drafted by the American Medical
Association (AMA) in 1847 recommended against physicians treating
family members. Their ethics state that "the natural anxiety and solicitude
which he experiences at the sickness of a wife, a child ... tend to obscure
his judgement, and produce timidity and irresolution in his practice"1
This ethical position was reaffirmed by the AMA in 1993 and continues to
the present.2 Further, the American College of Physicians recently stated
that physicians should "usually not enter into the dual relationship of
physician-family member or physician-friend"3. The American Academy
of Pediatrics position is similar: "Caring for one's children presents significant ethical issues."4 The exception to this rule is during emergency
situations during which no other physician is available, and then only
for a limited period of time.5
Continued on page 22

Central PA Medicine Spring 2018 21


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Table of Contents for the Digital Edition of Central PA Medicine Spring 2018

Central PA Medicine Spring 2018 - 1
Central PA Medicine Spring 2018 - 2
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Central PA Medicine Spring 2018 - 4
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https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2021
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter2020
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSummer19
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring19
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter19
https://www.nxtbook.com/hoffmann/CPAMed/CPMFall18
https://www.nxtbook.com/hoffmann/CPAMed/Summer2018
https://www.nxtbook.com/hoffmann/CPAMed/CPMSpring18
https://www.nxtbook.com/hoffmann/CPAMed/CPMWinter18
https://www.nxtbook.com/hoffmann/CPAMed/Fall2017
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Summer17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Spring17
https://www.nxtbook.com/hoffmann/CPAMed/CentralPAMedicine_Feb2017
https://www.nxtbookmedia.com