The Ethics of Medication

Yesterday, I went to the doctor, and he prescribed medication for reflux disease. When I went to pick up my prescription, the cashier told me the pharmacy could not fill it until they received authorization from the doctor. I asked whether the doctor's prescription was not authorization. It turns out, according to the pharmacist, that the insurance company will not pay for the medication without a written justification from the doctor.

Rather than needing doctor's authorization, the insurance company was rejecting his authorization. So, I get no treatment for my reflux, which hardly seems fair, but the situation is exasperatingly complicated.

It could be that my doctor, under the influence of pharmaceutical reps, prescribed an expensive medication that is no more effective than cheaper alternatives. If so, it may be in the best interest of everyone, except the doctor and pharmaceutical company, to reject payment for an expensive medication that offers no additional benefits over other medications. Praise to the insurance company for holding the line on costs.

It may be that the doctor knows that the new and expensive medication is more effective and has fewer side effects than alternatives. He may have prescribed what he feels will promote my health and healing better than any other treatment available. In this case, all thanks go to my doctor, and the insurance company is really quite evil.

Or, it could be that the insurance company rejects any expensive treatment with the hope that patients will give up and find cheaper treatments or go without treatment. This, of course, might save money in the short run, although rejecting claims costs money in itself. Sometimes, rejecting a claim is more costly than simply paying it. the amount of staff time and resources tied up on this one prescription is enough to give one pause. The pharmacy says the insurance company won't pay for the prescription, but I did not press them on how they know this. It is possible they simply consulted a list of preferred medications. It may be that they checked a computer database. Or, they may have actually made a phone call. Any of these options require employee time.

After determining that the drug was not a "preferred" drug, the pharmacy faxed a form to my doctor. If things go as planned, a member of the doctor's staff will obtain a statement and signature from him before completing the form and faxing it back to the pharmacy. This is an inefficient system at best.

In this case, the patient, me, is going without treatment for reflux, which is causing real problems and can lead, if untreated, to serious problems such as esophageal cancer, which frequently terminates in death. So, who is to blame for the suffering of the patient? Greedy pharmaceutical companies? Doctors under the influence of greedy pharmaceutical companies? Greedy private insurance companies? Or pharmacists who raise problems when there is no problem? I really don't know the answer.

Prairie Restoration

I've had a couple of blogs on the evils of lawns. After a nice trip to Wisconsin this weekend, I came back more knowledgeable about a number of things, one of them being Prairie Restoration. This is a movement to restore natural habitats. If you are interested in doing this, you can get help here: http://www.prairieresto.com/. If you don't live in an area associated with prairies, you can get information on restoring other natural habitats as well (wetlands, for example).

Thanks to the fine folks in Wisconsin who gave me an education on prairie restoration efforts!

Texas dismisses EU concerns over the death penalty

The European Union thinks Texas should consider halting executions before reaching the 400th killing by the state. In a BBC article, we learn that Robert Black, a spokesman for the Texas governor, said: "Two hundred and thirty years ago, our forefathers fought a war to throw off the yoke of a European monarch and gain the freedom of self-determination." How many fallacies are contained in this response? Well, it certainly has nothing to do with the death penalty, so it is missing the point or a red herring or something along those lines. It raises the specter of nationalism (I want to say "jingoism"), so it is flag waving (if it were directed at an individual, it would be an ad hominem attack).

It doesn't really matter. The real point is that the response from Texas ignores the primary arguments against the death penalty, which the EU stated clearly: 1. The death penalty is not a deterrent and 2. It is impossible to rectify a miscarriage of justice. According to the Innocence Project, 206 individuals convicted of capital crimes have been exonerated. We can only speculate as to how many more innocent people have been convicted and killed.

Our leaders feel no hesitation to comment on the actions of other countries' decisions. In the sense of fair play, we might expect Texas leaders at least attempt to defend the use of what appears to me to be an unjust practice rather than merely issuing proclamations that Texas does what Texas (or it's governor, anyway) wants.

What does it mean to believe in God?

When I ask what it means to believe in God, I am really being superfluous, because it is impossible to say what it means to believe in God without first answering what it means to believe. Stating it means to believe something is notoriously difficult. One hypothesis is that beliefs are thoughts about facts that occur to us in the form of sentences. For Descartes, thoughts that weren't expressed in language were not thoughts at all, though they may be passions or feelings.

The first objection, though, may be that not all thoughts or beliefs are actually expressed in sentences but that they could be. For example, most everyone believes that a regular-sized automobile is larger than a normal basketball, but few people ever express that belief in the form of a sentence. It is averred that someone holds the belief if they would answer "yes" when asked whether a car is larger than a basketball. We might complicate things by asking whether a dog would believe a car is larger than a basketball, and it seems many dogs act as if they believe cars are bigger than basketballs, but they can't express it in a sentence, even when queried.

So, is it enough to "act as if" something is true to substantiate belief in that something? Back to the original question, can we say someone believes in God if that person acts as if God exists? So, we might say someone believes in God if we see them praying, avoiding sin, or something else. On the other hand, we might run into serious conflict. Most people claim to believe in God and that God will provide a blissful afterlife. In other words, they express these beliefs in sentences. Their behavior, on the other hand, tends to reflect a general dread or terror of death or the afterlife. The behavior of many but not all self-proclaimed believers would indicate that they think death is the finality of life or the beginning of an awful punishment rather than a reward for a life well led.

Or, perhaps, these same people sincerely proclaim their belief in God, but their actions reveal a hidden belief that their lives have not been properly spent.