DOCTOR! vs: dOcTer?

"Cured yesterday of my disease,

I died last night of my physician."

-- Matthew Prior 1664-1721: "The Remedy worse that the Disease" (1727)



Fri, 19 Jun 2009 19:04:22 -0400 [06/19/2009 07:04:22 PM EDT]

Dear Mr. Tessier:


I am sorry to hear that you have encountered problems with your care here. Not knowing the details of your medical condition or the specific reason why Dr. X. declined to provide the release, I am not in a position to judge if the decision is appropriate or not. University of Michigan Health System has very strict guidelines on how we should proceed with providing the release. In general, we do not feel that hepatitis C on its own should be a reason for use of marijuana. Marijuana can accelerate progression of liver fibrosis, so any benefit must be weighed against medical risk. If you are requesting for its use to combat side effects associated with radiation or chemo therapy, that is very different, and Dr. K. may be in a better position to provide the release.


Let me know if I can be of further help.


Dr. L.

From:
Randall Tessier
To:

Subject:
Re: IMPORTANT

Dear Dr. L.:


You write, "we do not feel hepatitis C on its own should be a reason for use of marijuana." So, hypothetically, if a person had excruciatingly painful symptoms caused by the hep C virus, and found relief from medical marijuana, you would presume to deny them this treatment? You should know that signing the release is simply verification that a patient has one of the qualifying conditions, in my case, cancer and hep C. It in no way prescribes anything.


I would also caution you that "generalizing" about how disease affects specific individuals should be avoided in favor of making decisions on a case-by-case basis. There are side effects associated with hep C, like the severe itching brought on by lichen planus, that can be ameliorated by medical marijuana. I guess I'm asking what distinction you're making between hep C and cancer pain? Pain is pain, and relief is relief.


Regarding the "accelerated progression of fibrosis" research, I would be interested in seeing the data you base this on. Cherry picking particular studies, whether qualitative or quantitative, that support decisions wholly unrelated to what benefits the patient most, is often a convenient way of allowing moral judgments to supersede the patient's best interest.


Using marijuana for the relief of pain is not a moral issue, it's a medical matter.


Finally, shouldn't the patient have a say in weighing the risk/benefit equation.


It would seem to me that world renowned specialists at one of the most esteemed research hospitals in the world should be capable of showing at least the same wisdom and compassion as my primary care provider.


Best - Dr. Tessier



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