Conflict Issues and Special Topics of Medicine

Many think that a Doctor is free to do whatever they want. While many Doctors seem to be the ultimate authority, they are in fact, restrained by many rules and regulations. The violation of which can result in termination of their license. While dealing with medications doctors also face many ethical situations. The following is a conversation that I overheard today in the clinic.

Patient: “I don’t understand why you can’t just give me the generic for Suboxone! It’s a lot cheaper and my insurance doesn’t want to cover it anymore.”

Doctor: “This is an addiction clinic. The reason why I don’t just prescribe you the generic is because it can be abused easier. The generic does not come with the naloxone inhibitor, meaning it can be used inappropriately. As your doctor I cannot ethically give you a drug that can potentially be abused.”

Patient: “I don’t believe this! I’ve been clean for 5 years. You can’t treat me like a druggie.”

Doctor: “In addition to these legal standards, many patients do not do well on the generic versions of this drug. Many patients experience nausea, headaches, and are more prone to experience withdrawal symptoms. Unless I have a letter from your insurance, stating that they will not cover the Suboxone I will not switch you onto a generic. Suboxone is a controlled drug, and as such I cannot legally switch you to the generic brand simply because it is more affordable.”

Many physicians are forced to make decisions between things that are legally right and morally right in respect to their patients. Many issues that are controversial are really a part of something bigger. Once the big picture is achieved it can be easier to understand, which could be definition or genus and species. Cause and Effect are also powerful. Stating laws and Authorities (usually themselves or the findings of other doctors) are very persuasive. Special topics include what is ethically right and what is advantageous to the patient.