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23 septiembre, 2021

Doctors Should Avoid Being Bullied Into Giving Ivermectin

Hi. I’m Art Caplan at the Division of Medical Ethics at the New York University Grossman School of Medicine. I’ve been tracking — with some amazement, anger, and upset — the outbreak of interest in using ivermectin, a deworming medicine made by Merck, as a treatment for COVID-19.

Very recently, there was a patient at Amita Health Resurrection Medical Center near Chicago. She was an anti-vaxxer who wound up getting COVID-19 and was in the intensive care unit (ICU), and she wanted the hospital to give her ivermectin. They wouldn’t. She found a doctor who would prescribe it, but the hospital refused to give it anyway.

There have been other instances where courts have ordered ivermectin to be given to very sick people in ICUs at the request of relatives. The ivermectin story reminds me a little bit of the days when we were all worried about hydroxychloroquine, the unproven intervention that was touted by President Trump and many other people as a treatment for COVID-19, for which there were no data, no evidence, and no trials.

Sadly, the same is true for ivermectin. A little bit of information came out saying that it might be prophylactic in terms of avoiding getting COVID-19, but those studies were weak and not well controlled, and some of them have been withdrawn owing to the investigators being accused of falsifying data. There is not much of a database there.

If you look for studies showing that ivermectin helps people get better who are sick in the ICU, there’s nothing. This medicine has been around for decades and is used to kill worms in humans, particularly in places like Africa — Guinea worm — and in animals who have worm diseases. It’s hard to imagine a deworming medicine that kills parasites being effective against viruses.

What’s probably the most telling is that the CDC, the FDA, the AMA, the WHO, Merck, and many health commissioners in many localities, including Chicago, have said, “Do not use this drug.” It may be out there for certain human uses for worms. It may be something you could grab at the veterinarian’s office if it’s for sheep, but it is not intended for COVID-19. Don’t use it.

If you look at the situation, should you see a court order saying, “Give ivermectin to a patient,” my advice is to refuse it. You should not be giving dangerous, unproven medicines to anybody. A court may order you to do that, but I would resist. I have no doubt that you will win because of all these major groups coming out and saying, “It’s not the standard of care. Don’t use it.”

It may be a little bit of a hassle to ask the attorney for your clinic or hospital or your personal attorney to reject the order, but I would. It seems to me we don’t want medicine that works like this: I saw something on the Internet — bleach, gargles, ginseng, garlic, ivermectin — and I want it and I’m going to find some doctor who’s willing to prescribe it. Then you have to give it. That’s not how medicine works.

The way medicine should work is people with expertise set the standard of care in their own facilities. They don’t get bullied into doing useless, dangerous, and futile things by outsiders. When demonstrators go after doctors because they do the right thing and don’t prescribe something like ivermectin, their hospitals, medical societies, and medical professions should rise to their defense and denounce what is basically know-nothingism trying to overtake the battle against COVID-19.

Everyone who’s seeking ivermectin in the ICU that I’ve seen is unvaccinated. I think that tells us what the proper response is to the COVID-19 virus.

I’m Art Caplan at the New York University Grossman School of Medicine. Thanks for listening.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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https://www.medscape.com/viewarticle/958431?src=soc_fb_210922_mscpedt_news_mdscp_ivermectin


Créditos: Comité científico Covid

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