The narcotic drug problemBishop, Ernest S. (Ernest Simons)
Science
The narcotic drug problem
Bishop, Ernest S. (Ernest Simons)
Drug addiction
In such a situation the dominant theme has been the stamping out of
so-called “drug use.” The physician who under his best and honest
therapeutic judgment strove to meet the immediate indications of the
worthy and innocent addiction-disease sufferer by the administration
of opiate drug, incurred a danger of severe criticism and at times
of jeopardy to his liberties under the interpretation of his acts as
perpetuating a “habit.”
It cannot be denied that in some cases unscrupulous holders of medical
degrees have availed themselves of existing conditions in such a
way that their supplying of opiates to narcotic addicts constitutes
simply traffic in narcotic drugs and not the intelligent practice
of medicine. It should be a matter of serious consideration for
our lawmakers, administrators and judiciary, however, as to what
extent the performance of the occasional medical vampire should be
made a basis for the legal or administrative control of the honest
practitioner, and to what extent he should be enveloped by legal and
administrative restrictions, the innocent and unconscious violation
of whose technicalities may at any time be made a basis for criminal
procedure. It should be remembered that zealous administrators may not
have proper conception of the scientific facts of disease nor of the
practical problems of legitimate medical practice in addiction-disease.
The quality of the act in the determination of legitimate medical
practice is often if not as a rule more important than the mere act
itself. There has been as yet, so far as I know, no satisfactory legal
definition of legitimate medical practice. The author sees no reason
why the same rules and criteria as have developed or are formulated
for legitimate medical practice in other diseases might not be applied
to the treatment of addiction-disease. In a general way the legitimate
practice of medicine in the care of, handling of or treatment of
a disease consists of such medical attention, advice, instruction
and guidance, and clinical or therapeutic ministrations as may be
indicated by the needs of the individual case. In addiction-disease if
a physician proceeds upon the physical, clinical and other indications
exhibited in the individual case, being held responsible for reasonable
familiarity with such indications, and fulfilling to the best of
his available equipment and professional ability the general and
therapeutic requirements of each case, it is difficult for the author
to see how he can be held to be engaged in illegitimate practice.
He can of course be held responsible for reasonable familiarity
with available teaching and information on the subject treated by
him, and for average intelligence and honest application of medical
principles and practice. It seems to the author that legitimate
practice as determined in other diseases would go a long way towards
the elimination of the charlatan and shyster physician and would not
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