"Can We Legally Mandate Prevention Through Drugs?" Topic of CVMC's May 'Conversations in Ethics'

This month’s case study, taken from the McGraw General & Human Biology website, is called “Can We Legally Mandate Prevention Through Drugs?” The Amos Drug Company has developed a new drug that will prevent osteoporosis, one of the most dangerous conditions affecting older people, especially older women. In osteoporosis, calcium is leached out of the bones, which then become brittle and break easily. Osteoporosis can also cause serious compression fractures of the vertebrae and neck, as well as cause a great deal of pain as the condition progresses. The drug has cost millions to develop, test, and put on the market. It has no side effects, but it does have to be taken every day from puberty on. If this regimen is followed, the person will never develop osteoporosis. The drug is especially effective for those who are genetically predisposed to the condition.

This drug has an enormous potential market. Prior to its release, the only way someone could prevent osteoporosis was to take calcium supplements or increase the calcium in their diet; but this didn’t guarantee that a problem would not occur much later in life. With the new drug, if the individual takes one pill every day, there is no chance of developing osteoporosis.

Amos Drug Company is contemplating an interesting marketing plan. If all people over age 25 were required to take the drug, many people could be saved from a painful and crippling disease. So the company’s president has asked legislators in his state to consider passing a law requiring the drug for everyone. There is some precedent for a state stepping in to better the health of its constituents. In many states, genetic testing for certain conditions is required at birth; in others, the state often intervenes to force certain patients to have a procedure (such as a cesarean section or blood transfusion). If the drug became required by the state, the company would not only recoup all the money it had spent on research and development but make a huge profit and at the same time help many people.

Questions that may be discussed include the following: What would be Amos Drug Company’s argument to the representatives of the state legislature? Should people be required to take care of their health? What should be the part of the government in our health care decisions? How might insurance companies react to the law? If the law were passed, how would the courts deal with an individual who refused to follow the law?

A free lunch will be served to those who register no later than Tuesday, May 19, 2009 by calling Glenda Fowler at 828/326-3365.

Catawba Valley Medical Center’s Department of Organizational Learning is an approved provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Completion of this activity provides 1.0 contact hour.

Catawba Valley Medical Center is a not-for-profit, public healthcare system providing and promoting the physical, mental, emotional and spiritual well-being of the public in addition to serving as a center for health education, wellness services, preventative medicine and acute care. CVMC, twice recognized by the American Nurses Credentialing Center as a Magnet facility, was recently named as a “Distinguished Hospital for An Outstanding InPatient Experience” by J.D. Power and Associates as well as a Hospital of Choice by the American Alliance of Healthcare Providers.

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