Ethical Medicine?

I thought I had seen it all… but apparently not.  

I was called to see an old lady at her home one evening at 9pm.  All her family was gathered because they thought she was dying.  Her umpteen sons, daughters and grandchildren crowded the tiny bedroom.  They told me the patient had been fine the day before, and that she had gradually become weaker and weaker until she could no longer get out of bed.  Now she was nearly unconscious. 

As I enquired further, it transpired she had recently been started on a new medication for her symptoms of mild depression.  The medication was a tranquilizer – one that was rapidly addictive.  I told them the old lady´s symptoms were due to overdose from the tranquilizer and advised them to stop giving it to her. 

The family stopped it temporarily, and the old lady recovered, but continued to feel weepy, so one of her daughters took her back to the doctor who prescribed the same tranquilizer in lower dose.  The old lady immediately calmed down and the family was delighted. 

A few weeks later, once the old lady was addicted to the tranquilizer, the doctor told the family he would only continue to treat the patient if they paid him $1,500.  The tranquilizer is one of the very few drugs you really cannot buy in Ecuador without a prescription.  When the old lady stops taking it she develops headache, starts to shake and becomes agitated and upset.  The doctor has deliberately caused her to be in the situation that to continue to receive the prescriptions for the medicine she now craves, she has to pay him a huge sum of money.

Surely that is not what being a psychiatrist is all about? 

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