Not only since the health care reform has the question arisen as to whether everything really has to be treated, whether the “feasibility mania” of medicine does not overshoot the mark often enough. Unlike the ongoing discussion about the benefits and associated costs of medical treatment, the question of the measure and scope of a treatment is best posed to the critical patient himself.
With treatment seven days, without treatment one week
A good example of the fatal consequences of real “overtreatment” is the resistance of certain bacteria to antibiotics. Especially in the 1980s, antibiotics were often prescribed for colds and infections caused by viruses. In order to prevent so-called secondary infections, namely bacterial infections following viral infections. Together with an inconsistent intake practice, the antibiotic glut leads to certain germs no longer responding to antibiotic drugs. In the worst case, this can lead to death in the seriously ill. In the meantime, the treatment regimen for “banal infections” has changed somewhat. Today, in many cases, the focus is on treating the symptoms – an approach that can often be accomplished by simple means.
Giving the disease “time to run its course”
What has not changed, however, is the attitude of many patients. A visit to the doctor is not infrequently equated with the desire for an immediate cure or at least improvement. It is often forgotten that even “simple” colds and the self-healing process associated with them are subject to a rhythm that is controlled by biological and physiological factors. For example, the body reacts to the attack of a virus by mobilizing its defenses. In order for the body to properly counter the attacker, it must be clearly identified and the “right” defenses must be produced. And for this, the immune system needs a certain amount of time. This time sequence and the physiological processes can only be influenced to a limited extent. In the case of colds, one is better advised to allow one’s body the appropriate rest period and not to ignore the feeling of tiredness, fatigue and exhaustion. Those who end their visit to the doctor with decongestant nasal drops, cough syrup and possibly fever-reducing agents belong in bed afterwards with a period of rest and not in preparation for the next marathon or on the plane overseas.
Advice or stumbling blocks?
Many patients are certainly overwhelmed with assessing the meaning, measure and extent of their therapy. However, they too often rely on instructions and advice without voicing their own concerns and considerations and discussing them with their physician. Treatment instructions and compliance with them can only be successful if they are adapted to the patient’s circumstances – which, conversely, also requires the patient’s cooperation. However, anyone who already knows in the consulting room that certain medications are out of the question for him or that it is not possible to carry out a treatment in the intended form should communicate this openly. Open communication between doctor and patient is the cornerstone of successful cooperation between the two – and this may also include, under certain circumstances, the doctor advising against a treatment or the patient refusing the treatment or asking for alternatives (including to conventional medicine).
Patients are vulnerable
The question of whether and how much treatment a patient needs is often difficult for physicians to decide as well – after all, they do not want to expose themselves to the accusation of not having offered the patient everything. Pregnant women, for example, often have the experience of being offered an excess of preventive examinations or diagnostics in a form that is difficult to refuse. Regardless of the fact that pregnancy is not a disease, modern medicine is both a curse and a blessing here: it can cure many things and detect even more – but the ethical burden is immense. Pregnant women who have the well-being of their unborn child in mind do not want to expose themselves to the responsibility and reproach of not having done everything for their child in case of doubt. So they may take on tests and examinations whose consequences they cannot really assess. The results of such examinations (e.g. child malformations, hereditary diseases) can confront them with serious decisions (abortion yes or no), which they can hardly cope with psychologically.Anyone who decides to have amniocentesis or a triple test must be fully informed in advance about the consequences of the respective results and what they may mean for the father, mother and child. This is a task for society as a whole: the fact that examinations and tests are possible is the task of research and medicine. How their results are judged is a challenge for society as a whole.
Drug abuse and weighing the means.
Patience and common sense are needed when people manage themselves and their health. Quickly reaching for a pain pill instead of researching and treating the cause is one example. It is not uncommon for one tablet to turn into a drug addiction that exacerbates the cause of the illness. However, certain diseases and their treatments are also “fads” that change over the years. The drug “Ritalin,” for example, is prescribed for patients with attention deficit disorder. The phenomenon predominantly affects children. Within the last few years, therapy with Ritalin has been used much more frequently. The question must be allowed whether we perhaps live in a society that is becoming increasingly intolerant of such disorders and is seeking a quick solution to the “problem.” Alternatively, it should be considered whether it is not necessary to “treat” (in the sense of change) the society in which such disorders suddenly appear in greater numbers. In fact, there is no evidence that the number of children with the disorder has increased so dramatically. Also, the long-term effects of the drug have not yet been researched, and experts’ opinions on the subject differ widely. Parents and physicians are therefore well advised to thoroughly consider all therapy alternatives and decide together on a course of action.
Résumé
Should diseases be left untreated? No, of course not. After all, people are cured or lead much better lives with modern drugs and therapies. Does that mean you have to treat everything? Neither does it. But illness does not make you immature – patience and common sense should not be disregarded even in the case of illness.
