Fear as a Basis for Curtailing Choice

Worries about the medications that doctors prescribe are not new. Garrison Keillor's Fearmonger's Shoppe has carried a "prescription safety kit" for over four years, now:

"Poor penmanship among doctors is estimated to cause as many as 198,000 deaths a year. Imagine. Your doctor prescribes Viagra and the druggist gives you fifty
capsules full of Niagara laundry starch. How can you protect yourself against
this mistake? By carrying a safety kit from the Fearmonger's Shoppe,
which includes a box full of large, easy-to-read gummed letters."

After watching the misery of two friends who each stiffened up overnight when their Celebrex was abruptly stopped, I'm wondering where the proper balance might be in decisionmaking on whether or not to prescribe the many medications currently under scrutiny, and who really should be making the decisions.

Would it not be better if these patients could make an informed decision for themselves? It brings to mind again the JAMA comments by Dr Robert McNutt that I first mentioned here:

"Physicians should never make a choice for a patient -- even if the patient
wants the physician to do so."

Certainly I understand the decision of the physicians of these two patients, given the current public climate around medications and drug companies. And I am certainly not expert enough to know whether my friends should be on or off Celebrex.

That's not my expertise.

But the psychology of fear is my expertise, and this I know: a lot of power can be gained and wielded through fearmongering -- including, I'm afraid, intrusive power over the patient-physician relationship.

Now, that's scary...