Do No Harm

Before becoming a doctor, medical students must take the Hippocratic Oath. The initial statement of the oath is: “First, do no harm.”

As a patient navigator, I also take this oath to heart when I provide personalized guidance to patients and caregivers. Sadly, many in the medical field and drug industry don’t consider the meaning of this oath when they prescribe or market a drug. This is evidenced by the prescription of drugs that do little good, and continued inclusion of these therapies as comparators in clinical trials. Many can potentially do a lot of long term harm while not providing a benefit. The motivation by industry and medical provider may be profit or ignorance of better therapies or even not being terribly sensitive to the patient’s suffering.

That said, there is no “controversy” about prescribing drugs that are toxic, they are known to be toxic and ineffective period. The prescriber should consider the tolerability of a drug by looking at the patient individually, not as a member of a group. Questions to ask include:

· How old is the patient?

· Do they have history of other illnesses including mental illness?

· Do they plan on maintaining their fertility in the future?

Taking a thorough history and screening out those who won’t tolerate them is vital before prescribing any drugs.

How do you avoid the wrong therapy? Do some research first on scientifically backed websites such as ours, melanomainternational.org, the Mayo Clinic, or the National Institutes of Health. Look for large studies and see who has sponsored the study. Beware of the potential for conflict of interest in the support of the study. And you might ask on our forum what others in the community have experienced. Finally, ask your doctor if he/she would prescribe this drug to their husband and/or wife. If the answer is yes, ask them if they truly care about their spouse as well!

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