Dr Reese - Ethics...??

[Sparky]

The way it sounded on this thread is that if Dr Reese prescribed it for anything except for prostatic hypertrophy, he would be breaking the law, until now no one has mentioned writing that it is being prescribed for hairloss, and that the pill will be cut makes it ok. Surely Dr Reese's representative should have mentioned this at some point in the thread.

 

Thanks for the clarification Dr Shapiro!

[Bill - Seemiller]

Dr. Paul,

 

Your explanation really helped shed some clarity on prescribing medication for other than its intended use. Thanks for helping make sense of a confusing topic.

 

All the Best,

 

Bill

[CuriousJungleGeorge]

Originally posted by ukjoe:

I'm not sure what you think Dr Reese is right about in my original post. There has been a lot of confusion in many of the responses in respect to my original post but I know these boards go off in many tangents. A few of you are citing insurance fraud which is not an ethical dilemma but a legal issue. My Dr prescribes finastride for me. It isn't billed as something else other than for the DX of alopecia. It's not covered by my insurance and we are not trying to fool the insurance company. I pay out of pocket 100% so there are no legal concerns. I explained this to Dr Reese but it is what it is I guess.

 

Also there is a lot of mention that there is no generic drug for Propecia in this post and from Dr Reese. The FDA clearly labels finastride as a generic drug for Propecia. I'm not sure what other definition of "generic" one would reference for a drug other than that of the FDA.

 

As for Dr Reese, I have no argument with him at all. Ethics are a grey area. Some border on legalities and some do not and these are choices each and everyone of us must make and I respect his decision. I completely disagree with it and by his reasoning; the FDA does as well so it just doesn't make sense to me.

 

This kind of reasoning could make one wonder who does and does not have stock options in Merck...

 

To prescribe medication "off-label," for a physician, indeed is an "ethical issue"; you can drop it into the box of "medical ethics," if you must, but indubitable it falls into a philosophical category. Some doctors (i.e., some people) are more "practical," and may write for you a prescription such you can better afford a drug; others may feel it is wrong to steer from a more stringent path.

 

Let's bear in mind, this is a cosmetic issue; we aren't talking about expensive meds. you need to stay alive. If Dr. Reese will not prescribe for you a drug off-label ??” to "cover his ass," to stay within his moral zone, for whatever reason ??” you can be annoyed, fine, but it's certainly odd of you to accuse him of immoral conduct (even in this more recent post, you imply he benefits financially from not prescribing generic finasteride in place of Propecia).

[ukjoe]

CuriousGeorge:

 

The "cover is ass" comment was regarding him lying to me about his assistant missing the removal of sutures followed by his explanation of ethics, and nothing to do with his actual stance on prescribing medication. You apparently missed that part...

 

As for "To prescribe medication "off-label," for a physician, indeed is an "ethical issue". Physicians have been prescribing and pharmacies have been filling off-label\generic medications ever since I can recall... I'm not sure if there are any laws that look differently upon whether a medication is for cosmetic purposes or not so I have no idea where you are going with this...

 

 

As for your next accusation..., I accused him of nothing. I merely speculated about how his motives could appear to others. Especially as it sharply contradicts the FDA. Does he have stock in Merck? I don't know nor do I care. Nor am I annoyed about his stance. I have great respect for Dr Reese and his practice. But no more than the other Doctors who disagree with him. My audacity to question a Doctor really seems to stir the pot for some...

 

What I was annoyed with, as I will repeat for the last time in this post, was his failure to be up from with me about the sutures not with his stance on Propecia.

 

It is amazing how quickly these forums can digress.

[CuriousJungleGeorge]

Originally posted by ukjoe:

CuriousGeorge:

 

The "cover is ass" comment was regarding him lying to me about his assistant missing the removal of sutures followed by his explanation of ethics, and nothing to do with his actual stance on prescribing medication. You apparently missed that part...

 

As for "To prescribe medication "off-label," for a physician, indeed is an "ethical issue". Physicians have been prescribing and pharmacies have been filling off-label\generic medications ever since I can recall... I'm not sure if there are any laws that look differently upon whether a medication is for cosmetic purposes or not so I have no idea where you are going with this...

 

 

As for your next accusation..., I accused him of nothing. I merely speculated about how his motives could appear to others. Especially as it sharply contradicts the FDA. Does he have stock in Merck? I don't know nor do I care. Nor am I annoyed about his stance. I have great respect for Dr Reese and his practice. But no more than the other Doctors who disagree with him. My audacity to question a Doctor really seems to stir the pot for some...

 

What I was annoyed with, as I will repeat for the last time in this post, was his failure to be up from with me about the sutures not with his stance on Propecia.

 

It is amazing how quickly these forums can digress.

 

I wasn't quoting you when I said "cover his ass" ??” just giving an example of a reason for which he may refrain from prescribing medication off-label.

 

"Off-label" prescriptions have nothing to do with "generic medication" (not directly). Yes, doctors often do prescribe drugs off-label (i.e., for uses not approved by the F.D.A.), but whether or not to do so is a moral concern for one. As for this specific medicine's (finasteride's) being used cosmetically, I only mean to say, it isn't being prescribed for a life-supporting purpose, which may make a doctor less willing to prescribe it in the "off-label," arguably shady way.

 

You did accuse him of something when you "wondered" "who" owns stock in a pharmaceutical company (Merck): the accusation implicit is he is persuaded from financial gain not to prescribe Proscar off-label.

 

I don't feel your "audacity" (I don't see it as such) to question a doctor has "stirred anyone's pot"; simply, some of the things you said in your initial post have ended up feeling unjustifiably accusatory. Now, if you felt the doctor wasn't being up front with you about the sutures, fine; if he wasn't, he was wrong not to. Even if he was, it's wrong you were sent home without every suture's being removed (it's possible, but not really "OK"). If this was your main point, I agree, the thread indeed has digressed terribly.