Dr. Marc Siegel has been appearing frequently on TV and in print addressing Americans’ fears about possible bioterrorist attacks. Our government gives us advice, but as Dr. Marc says, “this business about duct tape and plastic and gas masks is ridiculous; not only wouldn’t it work, not only is it unnecessary, not only is the wrong message being sent, but it is also making plenty of money for hardware stores and duct-tape companies.” So do we have anything to fear from an attack? Ask Dr. Marc today. –The Editors
Dear Dr. Marc,
The number of people affected by food allergies–especially peanut allergy, the leading cause of life-threatening food allergic reactions–is growing. Many of those affected are children. In highly allergic people, anaphylaxis can cause death within minutes. Even minuscule exposure–oral, respiratory or tactile–can cause a reaction. There is presently no cure. Strict avoidance is critical. Given these factors, can you comment on the issue of keeping peanuts and peanut butter out of schools and other public places–particularly those that serve children–as a way of minimizing the hazard to their lives? In doing so, can you address the issue of community responsiblity versus individual rights in considering disabilities?
This is a very important question. Let me begin by saying that there is a treatment for anaphylaxis; rapid injection of epinephrine followed by steroids can be lifesaving, and people with known life-threatening food allergies should carry an epipen with them at all times. In the case of a child this may be administered quickly by the school nurse. Your question regarding human rights is a more difficult one, since food allergies may be hidden, but only in a small number of cases, even with allergies on the rise. Still, since the outcome may be so drastic, I am compelled to believe that such a food as peanut butter, which has a fair number of allergies attached to it, should be kept off the school menu. In this case the risk to a few outweighs the benefit to the many. There are other high-protein foods to eat, after all, though kids may not favor the healthiest of foods. I think community responsibility in this case requires preserving the safety of the individual.
Dear Dr. Marc,
More states are about to cap damages for pain and suffering in malpractice cases, and otherwise reduce the accountability of insurers, bad doctors and profit-motivated hospitals for the harm they do to people through slipshod medical care. Insurers want to increase profits by cutting down on the amount of doctor time and hospital time that patients use. They have been doing this in recent years through capitation, restrictive formulas, bogus “customary rates” and by routinely denying coverage for expensive treatments, among other things.
One of the few things that gives them pause in their drive to reduce the quality of care is the fact that if they go too far and kill someone, they’ll have to pay out of another pocket, through malpractice judgments. But if their malpractice liability exposure can be cut down to a predictable and manageable level, then the consequences of bad medicine will be just a cost of doing business. Insurers will be freer to refuse to include the better doctors and hospitals in their networks, putting many out of business. Is there any possibility that medical associations or doctors in general will figure out that these legal “reforms” are bad for good doctors?