When most people go to the doctor, they leave the office with a prescription for one or two medications to relieve the symptoms or cure a given condition. But what happens an increasing number of elderly patients leave the doctor’s office with prescriptions for 15, 18, or 20 drugs that are meant to cure the host of diseases that their doctors have diagnosed? The condition of having multiple, chronic health problems in known as multimorbidity. In the past, the public has perceived this predicament as rare, but in fact, it is not rare at all, and is rather common among elderly adults. Nearly two-thirds of people over age 65 and three-quarters of people over age 80 have been diagnosed with multiple chronic health conditions. These statistics place a significant weight on the issue of how to treat one, some, or all of the diseases at the same time in a single person.
At the center of this issue, lies a major bioethical component of drug treatment and patient care. People who are affected by multimorbidity linger in hospitals longer and experience a higher rate of preventable health conditions as well as overall shorter life spans. Most importantly, these types of patients are largely overlooked both in medical research and in hospital settings. Many research programs exclude people with more than one medical condition from volunteering because it complicates the research. So, there are currently not adequate opportunities and research initiatives for multimorbidity.
The lack of efforts to increase research on multimorbidity leaves the safe and effective treatment of these patients at a standstill. In effect, they are viewed by physicians and officials of the medical field as collections of malfunctioning parts that are nearly impossible to treat and have little or no significance in the field of medical research. This indifference towards multimorbidity becomes problematic as the numbers of people affected by this condition rises, especially as people age. So, the question is, should the physicians of the medical research field go out of their way to design potentially expensive, complicated trials that may have only a small possibility of ultimately figuring out a way to produce cocktail drugs for patients with multimorbidity, or should we simply turn our back on these helpless patients and let them waste away in our nation’s hospitals?
http://www.nytimes.com/2009/03/31/health/31sick.html?_r=1&ref=science&pagewanted=print
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Ethically, individuals should be given equal opportunities to medical treatment for their disease regardless of their age. However, I do not think it would be practical to go out of the way by researchers to engineer a cocktail to treat multimorbidity. As mentioned, the physicians think it is impossible to treat multimorbidity because it is a collection of diseases. I believe this is not much different from cancer. Both illness are more commonly a resultant of old age, as we acquire carcinogens from our environment. When the elderly get diagnosed with cancer, physicians do take into account their age and how well treatment will benefit the quality of their life. Perhaps it would be a better decision to simply prolong the quality of life with daily medications instead of attempting chemotherapy, which may or may not damage the senior’s quality of life. Similarly, I do not think it will be morally wrong to preclude seniors from a multimorbidity cocktail aiming to treat all their diseases. Taking their age into consideration, drugs that allows them to perform normal activities are sufficient in providing the quality of life they need.
While it may be argued that if multimorbidity is similar to cancer, why don’t researchers’ pay as much attention to it in drug development as they do to cancer treatment? One obvious answer is that cancer also appears in younger populations. But more importantly, cancer usually is associated to a source where the cancerous cells metastasized from or where the tumor resides. However, multimorbidity covers too much area in which successful treatment for each disease alone may not have been developed yet.
Yeah sorry this is 2 days late, I TOTALLY forgot about my blog response.
Multimorbidity is admittedly an unfortunate condition that should be given more publicity, especially given that I had no idea what it was before I read the blog post. I was inclined to think that the condition was not prevalent, but 'tis not the case.
Yet, why isn't any research done into this kind of ailment? Probably because it's so complicated to research, and any research done quite possibly would be useful only in rare cases. Simple probability tells us that once you get past the typical old-people diseases, finding two people with the same combination of diseases is exceedingly rare. Giving these people treatments without taking into account the cumulative effects can be dangerous without research, but is it practical to pour money into research that won't be widely used? I say no. Why isn't any research done to help prevent the strange freak accidents we hear about now and then? Because it isn't prevalent, that's why.
That's not to say that any research into multimorbidity. Research into the more common combinations of diseases, and into general procedures for treating senior citizens with multimorbidity is practical and significant, and I think at least SOME attention should be paid to this.
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