Should Marijuana Be Legal?

[SpecterGT260]

I never read pete's opinion as fact. I think there is a ring of truth to it, even though he did come off judgmental. That doesn't mean that his opinions aren't logical. I think you could have actually had a real debate if you countered his opinion clearly and concisely without burying your arguments in walls of text questioning his mental status and emoticons. Maybe he attacked you "unprovoked," but you certainly added fuel to the fire.

I didnt claim otherwise

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[Barcu]

I didnt claim otherwise

Well that was my point. I found that unnecessary. I guess it's the internet so I shouldn't complain.

 

[SpecterGT260]

This was the first post today from either you or pete. Not exactly attacking you unprovoked. The rest of his posts before this were from yesterday.

oh... so it only counts if it happened today
I didn't say anything about today. Pete tends to be as abrasive as I am with less reasoning behind the opinions, so we don't always get along well. If you want to play internet mommy this isnt the place to do it. Do you have something about the topic being discussed to add?

 

[SpecterGT260]

Well that was my point. I found that unnecessary. I guess it's the internet so I shouldn't complain.

Duly noted Sorry man, I'm totally down with a good civil discussion. But I am going to poke back when someone is being incredibly outspoken and dismissing any and all counterpoints with personal jabs. The complete dismissal of any dissenting view is counterproductive and just really annoying. There is no sense in doing anything other than trolling him right back. With a little luck he will get mad and leave and the discussion can proceed unhampered by raving moral convictions.

 

[FIREitUP]

I'm pretty sure that is what I said. In every case where it was opinion I said so (i.e. "IMO this only applies to those seeking weight loss). But I said at every turn that some patients may in fact be turned off by a fat doctor. I added that they can also be turned off by a fit doctor. Peter's points exclude this entirely as a possibility.

In a nutshell, the reason I am debating him on this is because his point is "My opinion is X and therefore it is what others think as well" where the reality is that patient opinions on this are as varied as patients are themselves. To unilaterally discredit doctors simply because of physique IS outragous. It would be like making the general statement that all DOs are dumber than MDs (just to make a close to home example). The reality of the situation is that many (but not all) DOs had more significant academic struggles than many (but not all) MDs. The generalization is false and the irony is that the only real morally questionable action occurring here is in drawing further conclusions from a flawed initial statement.

Just to reiterate - I agree this is a battle of absolutism. The kicker is that nothing I am saying is absolute in nature (except that ). This is the umpteenth thread this guy has done this in but if you look back every response to him that I have made has been non-absolute and in the interest of pulling things back to the middle, NOT the opposite extreme. The problem is that he keeps making counterpoints as if I am arguing for the opposite extreme and then calls me fat to boot Then there really isn't much else to do but question the cognitive ability that produced such responses

Haha, most of your arguments were tl;dr for me, I just assumed you were arguing the exact opposite. Carry on

 

[SpecterGT260]

Haha, most of your arguments were tl;dr for me, I just assumed you were arguing the exact opposite. Carry on

Its thanksgiving break. You got the time to read

 

[calvnandhobbs68]

We already pay for the healthcare of addicts! Legalizing reduces the number who use the product as we can see from alcohol prohibition data before, during, and after (also a decrease in crime after is repeal). Decriminalization is a step in the right direction. You must hate addicts because you refute all data and provide an emotional argument rather than logical

Do you not see that there's a huge difference between sending people to rehab for possessing heroin instead of putting them in jail and letting companies manufacture and distribute heroin wholesale? You're talking about two completely different things here. What happened in Portgual (which actually has higher rates of illicit drug use than before the decriminalization if you'll take a look at the link I provided and the papers it cites) has nothing to do with what you advocate.

You also don't seem to see that there's a difference between alcohol (and even cigarettes) and these other drugs you advocate for in terms of addiction potential. Most people can go out and have a few drinks a couple nights a week without affecting their own health or the well-being of those around them. Wanna try hitting the crack pipe or shooting up heroin a few times a week and see where that gets you? I can guarantee it'll turn into more than a few times a week pretty quickly. People tend to not "occasionally" use hard drugs as much as they'll insist otherwise.

 

[SpecterGT260]

We already pay for the healthcare of addicts! Legalizing reduces the number who use the product as we can see from alcohol prohibition data before, during, and after (also a decrease in crime after is repeal). Decriminalization is a step in the right direction. You must hate addicts because you refute all data and provide an emotional argument rather than logical

Prohibition did not increase the number of users.... The other points are fair, but legalization does not reduce the use. Do you think the number of people in colorado who went "Oh its legal now? Crap, now I don't wanna anymore" outweighs the people who went "It's legal now? Ok I guess I will give it a go"?

 

[peteB]

because many other drugs come with significant cost to others besides the user. Addiction is a legitimate problem.

And people don't get addicted to alcohol? Ever heard of alcoholism?

 

[SpecterGT260]

And people don't get addicted to alcohol? Ever heard of alcoholism?

So you think heroin is as addictive as alcohol then? Dude... Whatever man, I'm not listening to you. You don't even lift.

 

[Barcu]

oh... so it only counts if it happened today
I didn't say anything about today. Pete tends to be as abrasive as I am with less reasoning behind the opinions, so we don't always get along well. If you want to play internet mommy this isnt the place to do it. Do you have something about the topic being discussed to add?

I think you both are abrasive with the same amount of reasoning behind your opinions. I think patients do look at their doctors as examples. No, not every patient will do so. Nor will every patient respond the same way. And I agree that patients many times don't know about your personal life nor should they have a right to know. However, there are circumstances where they may find out about your personal life, and you may be judged for it. Whether you want to be or not, you may be a role model or example to your patients, and I think you should take that seriously. This doesn't mean that obese physicians are bad doctors. But they should strive for the same results that they recommend for their patients.

And my goal is not to play internet mommy. I just get tired of reading your posts and wondering why you are using so many words and emoticons to provoke arguments for no reason.

 

[peteB]

1) This is naive.
2) you still have not demonstrated by any means other than holding your breath and stamping your feet that this hypothetical fat doctor has not done the "best he can for them". Even in that language alone, he would have done the best HE can. But even without that minor technicality you have yet to establish that obesity is correlated to a lower standard of care. You just assume it to be true even if a patient could be more comfortable in that situation vs some super intense health nut like yourself.

This is just another example of that whole logic thing you struggle with



So.... you're cool with obese radiologists then, right? Just making sure that this IS some sort of logical progression leading to a conclusion and not a personal preference with half-baked rationales spun from it, then extended and, if you got your way, forced upon others who may not feel the same.

Just checking




It isnt wrong. You tell them to do that because they asked you what would fix x, y, and z. that is the correct answer. It remains the correct answer no matter what you shove into your mouth after those words come out of it. Your moral outrage at all of this is just.... I dunno. Some special mix of shallow, naive, and conceited. Any advice you give someone is tailored to them and the autonomous patient gets to take that advice or leave it. If your obese patient has edema due to HTN and wants to get rid of it, the correct answer is to lose weight (and whatever else you want to prescribe, but this is about weight). It is still the correct answer even if the doctor spits bacon flecks while saying it You are treating the patients like infants here. If the patient wants the symptom to resolve the patient will follow the advice. If the patient follows the advice the patient received a benefit. the doctor should get paid for that benefit he provided so he can buy more bacon



This isn't saying one thing and doing another. This is saying one thing to someone for whom that one thing applies, and then not doing that yourself.
The ONLY thing you have said that approaches accuracy is that some patients (and IMO only those who come in seeking help with weight) may not take a fat doctor seriously about such issues. They can find another doctor because a good many people know weight control is common sense and aren't dumb enough to think "oh well that doctor is fat, I bet he is lying to me and weight actually makes you healthier!" Seriously that the way you portray these patients. It's sad. But otherwise, the "saying one thing and doing another" argument only applies to issues of morality. i.e. conveying a moral truth to someone and then not following it.

It isnt morally wrong for a mechanic to recommend yearly services but neglect his own car. It may be dumb, but morally wrong? please.... same thing applies to the doctor in this case. If he is fat he only hurts himself, not his patient. Any patient who doesnt trust him will find a new doctor so that is a moot point. It's *****ic for that doctor to be obese because he understands all of the health issues with it, but morally wrong it is not. that is just a completely ridiculous statement. It is yet another example of you lacking the logic required for these discussions and stretching an unrelated statement (in this latest case "saying one thing and doing another") into a completely unrelated topic. That demonstrates a very poor understanding of all of this. Its akin to a child gasping at a naughty word. Why? because its naughty! "but but but, saying one thing and doing another is bad! mommy said so!" Seriously.... Even if we accept that absurdity for the sake of argument, you still can't link that by any reasonable means to patient harm or lower standard of care so the next layer of your concocted reality still falls apart.

Oh my god dude, just STFU already. Please stop. You're making yourself look worse and worse every post you make trying to take me down but you get nowhere.

The bottom line is this: A doctor who knowingly and willfully chooses to be unhealthy, whether that be by being obese or smoking or doing drugs or whatever, while at the same time preaching the virtues of abstaining from those things to his patients and knowing that there is a very good possibility that his patients will find out about his behavior is a two-faced hypocritical scumbag who doesn't deserve the title of physician. I'm sticking by that point and no further argument of yours is going to change my mind.

And regardless of all of this- any doctor who knows full well the health issues associated with obesity and smoking and still doesn't try to change his habits is an idiot.

 

[SpecterGT260]

And my goal is not to play internet mommy. I just get tired of reading your posts and wondering why you are using so many words and emoticons to provoke arguments for no reason.

how does "sh**s and giggles" grab you?

The rest of what you said did not accurately describe what my point was anyways. It's fine, if they were too long I suppose I can see why you would think I am arguing the opposite of what peter is. Doesnt change the reality that I am not arguing that. That said, if they were too long that you didnt read them (as would be indicated in your response) then you arent really sick of reading them, you're sick of scrolling. Deal with it The posts were for peter and anyone who felt the desire to read them. If that isn't you, you are welcome to... you know... not read them and stuff

 

[peteB]

So you think heroin is as addictive as alcohol then? Dude... Whatever man, I'm not listening to you. You don't even lift.

So we're talking about grades of addiction now? Alcohol addiction isn't enough addiction to count as addiction? It's not as bad a problem for you? Ever actually met an alcoholic and heard their story?

Bro, like I said before, lifting the fork isn't really lifting.

 

[SpecterGT260]

The bottom line is this: A doctor who knowingly and willfully chooses to be unhealthy, whether that be by being obese or smoking or doing drugs or whatever, while at the same time preaching the virtues of abstaining from those things to his patients and knowing that there is a very good possibility that his patients will find out about his behavior is a two-faced hypocritical scumbag who doesn't deserve the title of doctor. I'm sticking by that point and no further argument of yours is going to change my mind.

FINALLY! you make a statement that isnt over extended or irrational. I can agree with everything you said here.

And you thinking I am making myself look "worse and worse" doesn't do much about a majority of long standing members here calling you a troll in nearly every thread you enter I'm ok with how I look, thank you

 

[peteB]

FINALLY! you make a statement that isnt over extended or irrational. I can agree with everything you said here.

And you thinking I am making myself look "worse and worse" doesn't do much about a majority of long standing members here calling you a troll in nearly every thread you enter I'm ok with how I look, thank you

They call me a troll because I have strong opinions and I stick by them. I'm not afraid of controversy. I'm not a kumbaya let's all agree to disagree and we are all partially right kind of guy. That's just not me and will never be me. I have conviction in my beliefs. I know for a fact that a lot of people appreciate that too.

A troll is someone who's out to create controversy. That's not my aim. I simply state my beliefs and stand by them. If it creates controversy that's because they are controversial beliefs, but I'm not going to water them down to not offend. I'm not afraid of offending people by expressing my views and you shouldn't be afraid to offend me either. I can take it.

 

[Barcu]

how does "sh**s and giggles" grab you?

The rest of what you said did not accurately describe what my point was anyways. It's fine, if they were too long I suppose I can see why you would think I am arguing the opposite of what peter is. Doesnt change the reality that I am not arguing that. That said, if they were too long that you didnt read them (as would be indicated in your response) then you arent really sick of reading them, you're sick of scrolling. Deal with it The posts were for peter and anyone who felt the desire to read them. If that isn't you, you are welcome to... you know... not read them and stuff

No. I actually did read what you wrote, and I know you are not arguing the opposite of what pete said. That's why I called you out. Instead of actually making a point, you are more concerned with provoking a response. Go nuts then.

 

[SpecterGT260]

So we're talking about grades of addiction now? Alcohol addiction isn't enough addiction to count as addiction? It's not as bad a problem for you? Ever actually met an alcoholic and heard their story?

Bro, like I said before, lifting the fork isn't really lifting.

no, we are talking about probability of negatively impacting public well being and weighing it against personal freedoms. What exactly is your point here? The post I responded to (although I thought you were making the point rhetorically) suggested we make all drugs legal since we already have a couple that can be damaging. But here.... this post would only stand as a reasonable defense for outlawing alcohol in addition to the other drugs. Is that your point? Bring back prohibition? Or are you trying to advocate on the side of personal freedom? This is why I dog on your for your use of lojik..... You seem more interested in nitpicking the individual points made than in forming a single coherent position.... And before you try to spin that around on me, my position has been moderate the entire time and the only things I have picked out from your arguments are the things that deny a middle ground.

 

[peteB]

no, we are talking about probability of negatively impacting public well being and weighing it against personal freedoms. What exactly is your point here? The post I responded to (although I thought you were making the point rhetorically) suggested we make all drugs legal since we already have a couple that can be damaging. But here.... this post would only stand as a reasonable defense for outlawing alcohol in addition to the other drugs. Is that your point? Bring back prohibition? Or are you trying to advocate on the side of personal freedom? This is why I dog on your for your use of lojik.....

I'm saying that the "alcohol is legal, so why not marijuana" doesn't make sense. Because you can take that one step further and apply it to another drug, and another, and another. When are you going to draw a line and say this is it. Where will that line be and how will you determine it?

 

[bauber]

I've already established that the drug policy of Portugal is not "legalization". Go look up what their "de-criminalization" actually means and the sanctions you can still get for posession (not to mention dealing and distribution are still subject to criminal penalties). It doesn't help that they don't have great records about these things before 2001...the year decriminalization kicked in.

I never said Portugal had legalization. I don't see why countries should not follow their model of decriminalization.

 

[SpecterGT260]

No. I actually did read what you wrote, and I know you are not arguing the opposite of what pete said. That's why I called you out. Instead of actually making a point, you are more concerned with provoking a response. Go nuts then.

I made lots of points. It is perfectly possible to do both things simultaneously. Chill out

 

[type b pharmD]

I'm interested in this thread cause it really uncovers vast areas of unspoken assumptions and the sort of moral authority that can get imbued in health professionals during training and practice!

As far as the marijuana goes, of course it should be legalized and taxed like alcohol, for the reasons everyone else in the thread has mentioned.

I'm more concerned with the idea of health professionals being expected to be the "pinnacle of health" in the community, which flys in the face of the freedom and personal determination that this country was founded on.

Not allowing health providers to participate in certain life choices or activities, as one poster above seems to advocate, is no less obnoxious toward people's liberties than penalizing someone for smoking a plant !!

I say this as a person who uses tobacco, drinks more alcohol daily than is recommended, eats fast food and junk food as about 50% of my diet (am not overweight but could see myself getting there), and who would readily admit to using recreational substances if the social and medical climate surrounding them was less ****ed up.

You may ask , what does a pharmacist care about this thread and this topic. Well, the same stigma about certain personal choices is passed down in pharmacy education, and I was about a hairs width away from going for my MD and am anxious for future students to have to experience someone like peteB lecturing from a moral high ground.

The situation is as follows:
as a HCP (healthcare professional), you are not fundamentally in the profession of teaching people how and why to make decisions about their lives. The types of professions that attempt to show and lead people toward a specific code of conduct, value choices, and personal beliefs include teachers, counselors, and clergy. As a HCP, it is my JOB to treat people to improve their health and to educate them about health information.

Do I understand that my life choices are going to shorten my lifespan and lead to health problems? Yes. and I will do my damndest to make sure patients know about the benefits or consequences of any health related life decision (medication, treatment, diet and exercise, what have you), since it is my job.

It is not our job to motivate people to change their lives. It is our OPTION, if we want, to help inspire people around us toward decisions that improve their health. It is our JOB to teach them the information, provide them with the truth, and offer our assistance.

Telling people flat out to abstain from substance use, go on a strict diet, etc , sure it must make you feel fuzzy warmth from having some type of moral high ground , but it is illusory, since first of all, patients arent listening, and second of all, there is absolutely no way you can be sure that these decisions are right for the person.
--devils advocate example:
---You tell an overweight patient who drinks too much that they really need to stop drinking and go on a diet. The patient, under the false impression that you are a saint and some type of uber-healthy holy man, attempts to follow your advice (obviously not real world example since they never do that). In doing so, they gain an additional 15 years on their lifespan. The consequences are that because they didnt go out to that bar, party, concert, etc, they miss out on life experiences, meeting their romantic partner, , etc, and become depressed because, in reality, their old lifestyle had led them to happiness, relaxation, and acceptance of life. Now, because of you, someone who invented a moral high ground to improve their ego, this patient is now clinically depressed and misses out on enjoyable and rewarding life experiences.

Lets not forget to mention that by living 15 more years, they suck back about $400,000 more from taxpayer supported basic health maintenance, social security, and societal resources. (all while potentially wishing they hadnt listened to that Dr. Saint back in the day).

So we see that the moral 'high ground' , is really fictional in the first place. There is no predicting how a single set of value choices will play out in the lives of thousands of unique individuals. Sure you will save some people from an MI or a obesity induced DM2, and maybe save more resource than otherwise, but none of that has anything to do with your personal choices as an HCP.

If i went to see a doctor, and all they told me was "do this, do this, and do this, because you have to because it's good for you" , I would completely write them off due to the fact that ive been raised in a society where freedom and individuality is valued. I dont go to a HCP to be controlled or told what to do, I go there to get medical INFORMATION and treatment.

The problem is thinking that as a doctor, you "know better". The truth is you know MORE, and that is what people are paying for, not for the morality speech and recommendations. As a doctor (or hcp) it is your ethical and moral obligation to share this information (ie to inform patients, "hey that is gonna take a few years off your life or you may be more at risk for x or y to occur). You are not their healthcare decision maker, THEY ARE.

Just like with marijuana, it is every individual's inalienable right to make choices for their body and life. If this includes making a tradeoff by sacrificing x health utility for x years or accepting x% risk of an MI or whatever condition, in exchange for receiving a specific benefit (being high, well fed, drunk, what have you) at the moment, that is their perogative. The way I see it, since I was granted the societal freedom to make these tradeoffs, I should at least respect other people's right to do the same.



TLDR version:

Disrespecting patient's autonomy and desires is MUCH more immoral and unethical than not 'practicing what you preach'. As an HCP, we should be striving to be giving patients clear and unbiased health information, and helping them realize the consequences of their actions.

When you ignore a patient's autonomy and freedom by preaching at them, you have basically already lost that patient. This has been proven over and over in the evidence. By doing that, you as an HCP are breaching your ethical obligation to serve the patient best. We never swore an oath as providers to live a certain way and to preach that way to our patients. We swore we would help people, and the first step toward that is realizing they are individuals and that people deserve to make their own choices in light of the risks and benefits.


WHEW! glad i got that off my chest, and apologies to anyone who got bored or fell asleep reading it.

 

[SpecterGT260]

I'm saying that the "alcohol is legal, so why not marijuana" doesn't make sense. Because you can take that one step further and apply it to another drug, and another, and another. When are you going to draw a line and say this is it. Where will that line be and how will you determine it?

In doing so you completely deny the existence of other defining lines. Yes, grades of addictiveness are important. If not, why do we have more than 2 schedules for our drugs? What defines schedules II-V? Abuse potential

EVERYTHING in policy, at least when it is concerned with denying personal freedoms, is focused around an arbitrary line in the sand. EVERYTHING is graded according to terms that groups of people find acceptable. The probability of someone developing alcoholism is actually pretty slim. The per use chances of getting hooked are minuscule. Match that to heroin where a single hit can hook you with no predisposing factors, and a new line in the sand becomes pretty easily identified.

 

[peteB]

My point is you never reach a frequency which is needed for most patients. People see there PCP once every few months, max?

When we treat people for being an alcoholic, we tell them to go to 12 step class everyday for 3 months without missing a day. Even this is marginally effective. That is pretty constant motivation and still isn't enough for most.

Its kinda like speeding. When you get a ticket you slow down for a few days, and then keep driving a little faster. Especially on roads where you never see speed traps. The same applies to the days after a doctor's visit.

The mac analogy doesn't really make sense. Buying a computer is a single decision. People can be persuaded with trendy marketing. Losing weight is an on going decision every hour of every day for the rest of your life. You need an internal reason or motivation.

The fact that the PCP's impact on the person's life is lower than other people/things (in your opinion), doesn't mean it's not important. Every bit counts. Besides, some people really look up to and respect their doctors and consider them their role models. I know many patients like this.

Is it really that burdensome on a doctor to make a few life changes that are not only good for themselves but also will have a positive impact on their patients? Are you not willing to go the extra mile for your patients, especially when it benefits you as well?

 

[SpecterGT260]

I'm interested in this thread cause it really uncovers vast areas of unspoken assumptions and the sort of moral authority that can get imbued in health professionals during training and practice!

As far as the marijuana goes, of course it should be legalized and taxed like alcohol, for the reasons everyone else in the thread has mentioned.

I'm more concerned with the idea of health professionals being expected to be the "pinnacle of health" in the community, which flys in the face of the freedom and personal determination that this country was founded on.

Not allowing health providers to participate in certain life choices or activities, as one poster above seems to advocate, is no less obnoxious toward people's liberties than penalizing someone for smoking a plant !!

I say this as a person who uses tobacco, drinks more alcohol daily than is recommended, eats fast food and junk food as about 50% of my diet (am not overweight but could see myself getting there), and who would readily admit to using recreational substances if the social and medical climate surrounding them was less ****ed up.

You may ask , what does a pharmacist care about this thread and this topic. Well, the same stigma about certain personal choices is passed down in pharmacy education, and I was about a hairs width away from going for my MD and am anxious for future students to have to experience someone like peteB lecturing from a moral high ground.

The situation is as follows:
as a HCP (healthcare professional), you are not fundamentally in the profession of teaching people how and why to make decisions about their lives. The types of professions that attempt to show and lead people toward a specific code of conduct, value choices, and personal beliefs include teachers, counselors, and clergy. As a HCP, it is my JOB to treat people to improve their health and to educate them about health information.

Do I understand that my life choices are going to shorten my lifespan and lead to health problems? Yes. and I will do my damndest to make sure patients know about the benefits or consequences of any health related life decision (medication, treatment, diet and exercise, what have you), since it is my job.

It is not our job to motivate people to change their lives. It is our OPTION, if we want, to help inspire people around us toward decisions that improve their health. It is our JOB to teach them the information, provide them with the truth, and offer our assistance.

Telling people flat out to abstain from substance use, go on a strict diet, etc , sure it must make you feel fuzzy warmth from having some type of moral high ground , but it is illusory, since first of all, patients arent listening, and second of all, there is absolutely no way you can be sure that these decisions are right for the person.
--devils advocate example:
---You tell an overweight patient who drinks too much that they really need to stop drinking and go on a diet. The patient, under the false impression that you are a saint and some type of uber-healthy holy man, attempts to follow your advice (obviously not real world example since they never do that). In doing so, they gain an additional 15 years on their lifespan. The consequences are that because they didnt go out to that bar, party, concert, etc, they miss out on life experiences, meeting their romantic partner, , etc, and become depressed because, in reality, their old lifestyle had led them to happiness, relaxation, and acceptance of life. Now, because of you, someone who invented a moral high ground to improve their ego, this patient is now clinically depressed and misses out on enjoyable and rewarding life experiences.

Lets not forget to mention that by living 15 more years, they suck back about $400,000 more from taxpayer supported basic health maintenance, social security, and societal resources. (all while potentially wishing they hadnt listened to that Dr. Saint back in the day).

So we see that the moral 'high ground' , is really fictional in the first place. There is no predicting how a single set of value choices will play out in the lives of thousands of unique individuals. Sure you will save some people from an MI or a obesity induced DM2, and maybe save more resource than otherwise, but none of that has anything to do with your personal choices as an HCP.

If i went to see a doctor, and all they told me was "do this, do this, and do this, because you have to because it's good for you" , I would completely write them off due to the fact that ive been raised in a society where freedom and individuality is valued. I dont go to a HCP to be controlled or told what to do, I go there to get medical INFORMATION and treatment.

The problem is thinking that as a doctor, you "know better". The truth is you know MORE, and that is what people are paying for, not for the morality speech and recommendations. As a doctor (or hcp) it is your ethical and moral obligation to share this information (ie to inform patients, "hey that is gonna take a few years off your life or you may be more at risk for x or y to occur). You are not their healthcare decision maker, THEY ARE.

Just like with marijuana, it is every individual's inalienable right to make choices for their body and life. If this includes making a tradeoff by sacrificing x health utility for x years or accepting x% risk of an MI or whatever condition, in exchange for receiving a specific benefit (being high, well fed, drunk, what have you) at the moment, that is their perogative. The way I see it, since I was granted the societal freedom to make these tradeoffs, I should at least respect other people's right to do the same.



TLDR version:

Disrespecting patient's autonomy and desires is MUCH more immoral and unethical than not 'practicing what you preach'. As an HCP, we should be striving to be giving patients clear and unbiased health information, and helping them realize the consequences of their actions.

When you ignore a patient's autonomy and freedom by preaching at them, you have basically already lost that patient. This has been proven over and over in the evidence. By doing that, you as an HCP are breaching your ethical obligation to serve the patient best. We never swore an oath as providers to live a certain way and to preach that way to our patients. We swore we would help people, and the first step toward that is realizing they are individuals and that people deserve to make their own choices in light of the risks and benefits.


WHEW! glad i got that off my chest, and apologies to anyone who got bored or fell asleep reading it.

wow... that IS kind of annoying when someone does that

Sorry guys


JK pharm, I read the post. Everything you said is what I have been getting at all this time.

 

[peteB]

In doing so you completely deny the existence of other defining lines. Yes, grades of addictiveness are important. If not, why do we have more than 2 schedules for our drugs? What defines schedules II-V? Abuse potential

EVERYTHING in policy, at least when it is concerned with denying personal freedoms, is focused around an arbitrary line in the sand. EVERYTHING is graded according to terms that groups of people find acceptable. The probability of someone developing alcoholism is actually pretty slim. The per use chances of getting hooked are minuscule. Match that to heroin where a single hit can hook you with no predisposing factors, and a new line in the sand becomes pretty easily identified.

What about cigarettes? They're a lot more addictive than alcohol. The per use chance of getting addicted to cigarettes is very very high. Studies have shown that nicotine is actually just as hard or possibly even harder to kick than heroin! Then why are cigarettes legal?

 

[SpecterGT260]

Is it really that burdensome on a doctor to make a few life changes that are not only good for themselves but also will have a positive impact on their patients? Are you not willing to go the extra mile for your patients, especially when it benefits you as well?

The only real problem here is that you equate disagreement with you with the things above. If I am being completely blunt and honest, given the limited number of hours in the day I can think of a good many ways to go above and beyond for my patients that will carry greater impact than pumping out a few reps before work and investing in flack seed. And no... doing it all isn't a viable option. When it comes to being in shape, "do it for yourself" is a much stronger argument than "do it for your patient".

 

[bauber]

 

[peteB]

I
---You tell an overweight patient who drinks too much that they really need to stop drinking and go on a diet. The patient, under the false impression that you are a saint and some type of uber-healthy holy man, attempts to follow your advice (obviously not real world example since they never do that). In doing so, they gain an additional 15 years on their lifespan. The consequences are that because they didnt go out to that bar, party, concert, etc, they miss out on life experiences, meeting their romantic partner, , etc, and become depressed because, in reality, their old lifestyle had led them to happiness, relaxation, and acceptance of life. Now, because of you, someone who invented a moral high ground to improve their ego, this patient is now clinically depressed and misses out on enjoyable and rewarding life experiences.

This is an ABSURD stretch. Yeah maybe if I don't swat a fly x will happen then Y will happen then Z will happen and the world will end. Give me a break.

I didn't "invent" a moral high ground. This is what our profession teaches and expects us to maintain and promote. If you don't like it, find another profession. In your case you have, so good for you. A doctor in my opinion should be like a counselor or clergy. That's just what I feel. Doctors have the respect and trust in our society to make a lot of change and do a lot of good. But you guys want to sabotage that because you want to party and have a good time and not take your responsibilities seriously. If you ask me that's not only morally wrong, it's selfish.

If you're looking for a job where you just read off a script and it doesn't matter what your morals or ethics or values are, then why not work at a call center or something.

 

[peteB]

I can't believe I have to argue with med students why it's bad to be obese or smoke. I thought this would be a no brainer for a person getting an MD.

 

[SpecterGT260]

What about cigarettes? They're a lot more addictive than alcohol. The per use chance of getting addicted to cigarettes is very very high. Studies have shown that nicotine is actually just as hard or possibly even harder to kick than heroin! Then why are cigarettes legal?

I havent seen such studies.... nor do cigarettes come with the debilitating immediate effects that heroin does. The vast majority of junkies have no means by which to be productive. As I said before, these people don't fall out of productivity because the drug is illegal. That is just the effect of the drug. Its legality doesn't impact this in any regard.

That said, I think tobacco is disgusting and completely useless. I dont personally understand why people do it nor would I miss it at all if it were to go away. It is a drain on our healthcare system which also pisses me off. However, objectively I do feel that the health consequences to legalizing heroin are much worse than they are for keeping cigarettes legal. Could you imagine what would happen if you could go down to the grocery store and buy a bag of heroin whenever you wanted? The stuff isnt expensive any more. It may even be comparable to a carton of cigs. For fun lets just pretend every smoker in america is a heroin junky. We may have a drop in treatment of chronic conditions, but Id bet it is because most of them don't make it that long. The community also loses productive hours from all of these people. junkies arent exactly stepping outside for a hit and then getting back to work. There are more differences between the illicit substances and legal drugs than there are similarities.

 

[SpecterGT260]

This is an ABSURD stretch. Yeah maybe if I don't swat a fly x will happen then Y will happen then Z will happen and the world will end. Give me a break.

I didn't "invent" a moral high ground. This is what our profession teaches and expects us to maintain and promote. If you don't like it, find another profession. In your case you have, so good for you. A doctor in my opinion should be like a counselor or clergy. That's just what I feel. Doctors have the respect and trust in our society to make a lot of change and do a lot of good. But you guys want to sabotage that because you want to party and have a good time and not take your responsibilities seriously. If you ask me that's not only morally wrong, it's selfish.

If you're looking for a job where you just read off a script and it doesn't matter what your morals or ethics or values are, then why not work at a call center or something.

stop using my word. Its MINE

 

[SpecterGT260]

It is and apples to illegal oranges comparison until you assume equal access and availability to all of those. The average alcohol user has far fewer issues and risks than the average heroin user. A far higher % of heroin users are addicts than in alcohol users.

 

[SpecterGT260]

I can't believe I have to argue with med students why it's bad to be obese or smoke. I thought this would be a no brainer for a person getting an MD.

That is your problem... (im pretty sure Ive said this multiple times) you think people are disagreeing with that statement. I'm not sure how you think this... but your posts routinely demonstrate that this is what you think

 

[peteB]

I havent seen such studies.... nor do cigarettes come with the debilitating immediate effects that heroin does. The vast majority of junkies have no means by which to be productive. As I said before, these people don't fall out of productivity because the drug is illegal. That is just the effect of the drug. Its legality doesn't impact this in any regard.

That said, I think tobacco is disgusting and completely useless. I dont personally understand why people do it nor would I miss it at all if it were to go away. It is a drain on our healthcare system which also pisses me off. However, objectively I do feel that the health consequences to legalizing heroin are much worse than they are for keeping cigarettes legal. Could you imagine what would happen if you could go down to the grocery store and buy a bag of heroin whenever you wanted? The stuff isnt expensive any more. It may even be comparable to a carton of cigs. For fun lets just pretend every smoker in america is a heroin junky. We may have a drop in treatment of chronic conditions, but Id bet it is because most of them don't make it that long. The community also loses productive hours from all of these people. junkies arent exactly stepping outside for a hit and then getting back to work. There are more differences between the illicit substances and legal drugs than there are similarities.

OK, I see your point.

I agree that tobacco is useless and is a huge drain on our healthcare system. No matter what smokers say, the fact is that their decision to smoke is affecting us all.

 

[type b pharmD]

I can't believe I have to argue with med students why it's bad to be obese or smoke. I thought this would be a no brainer for a person getting an MD.

You arent. You're just desiring to make it into that argument because it is an absurdly winnable one for yourself.

I would hope we all know that obesity, smoking, drug use, alcohol use, results in health harms.

Not sharing that info with a patient would be borderline illegal and a breach of ethics.


But one would hope that even YOU could see that it doesnt have anything to do with making those tradeoffs.

As a human and as an american, as doctors or HCPs we are allowed to make those tradeoffs if we wish.

There was nobody before who said, you HAVE to accept these restrictions on your life in order to be a physician or HCP. It wasnt in my ethical oath, it wasnt in my application packet, and it isnt in any licensing or employment contracts. Hm where is the source of this then? Answer: it is from people like yourself who feel high and mighty (or in your words, "conviction and strong personal beliefs". Also from the touchy feely academia, which as we all know, is not the real world.

It is time to wake up pete, doctors are not held on high as gods anymore. Thinking that that is your path and calling is one thing, and more power to you, im sure you will be healthy and inspire patients to be healthy. But telling people what to do with their life is a terrible place to start out from as an HCP, whether it's people on here or your patients.

 

[SpecterGT260]

OK, I see your point.

I agree that tobacco is useless and is a huge drain on our healthcare system. No matter what smokers say, the fact is that their decision to smoke is affecting us all.

Which is why I would personally be in favor of denying anything other than hospice and supportive care to smokers for smoking related illness. But I guess a happy medium is to just charge them (and obese people, this is totally fair for them too) more for insurance.

 

[SpecterGT260]

You arent. You're just desiring to make it into that argument because it is an absurdly winnable one for yourself.
.

Its called a Straw Man

 

[Marcus Brody]

Yes, and no taxes or age restrictions

 

[link2swim06]

OK, I see your point.

I agree that tobacco is useless and is a huge drain on our healthcare system. No matter what smokers say, the fact is that their decision to smoke is affecting us all.

But smoking reduces healthcare costs...

 

[Geebeejay]

what is the definition of "harm" used here? How are anabolic steroids less harmful than pot? alcohol? I disagree with this graph on many levels.

 

[SpecterGT260]

what is the "harm to others" associated with weed?

The only bad thing about a pot head is their incessant bitching about how it should be legal... which will go away if it is legalized

 

[calvnandhobbs68]

what is the "harm to others" associated with weed?

The only bad thing about a pot head is their incessant bitching about how it should be legal... which will go away if it is legalized

Seriously, the second I saw they put weed above benzos overall I just went Not sure where the "harm to others" is coming from either.

 

[link2swim06]

what is the "harm to others" associated with weed?

The only bad thing about a pot head is their incessant bitching about how it should be legal... which will go away if it is legalized

Impaired driving
House fires (similar to cigarette smoking)
2nd hand smoke

 

[SpecterGT260]

Impaired driving
House fires (similar to cigarette smoking)
2nd hand smoke

I will give you impaired driving.

The other two not so much... the smoke itself is significantly safer than cig smoke and it isnt very often you are smoking a bowl and the people within 2nd hand range are doing anything other than waiting for you to pass it around. 2nd hand smoke and weed isnt really a thing...

 

[KinasePro]

For the NPR fans among us: Tom Ashbrook discussed this issue on air last month and had people from both sides weigh in. Worth a listen if you like that sort of thing.

Plus, Tom Ashbrook is a boss.

 

[MiracleforMD]

I think a more important poll needs to be done:

Who should be banned?
A) peteB
B) SpecterGT260
C) Both

 

[SpecterGT260]

Can we add an option for pre-meds trolling the allo boards?

 

[MiracleforMD]

Can we add an option for pre-meds trolling the allo boards?

Interesting that you call my behavior trolling and not yours and peteB's incessant arguing in every single thread (many of which other people are genuinely interested in, like this one).

 

[SpecterGT260]

also interesting that you felt the need to bring it back to that after the conversation had turned on its own back to the OP

Ok scooter, shoot: Say something on topic since you are so interested. one, two, three go....