Contributed to a thread at Open Book on patients receving Accutane. Female patients are required to sign that they are using 2 forms of contraceptives, have negative pregnancy tests, etc. Lots of folks there are incensed that this makes Catholic women have to (1) lie, (2) use contraceptives in violation of their beliefs, (3) some combination of (1) & (2), plus (4) suspicions that this is all some ploy of "Big Drug Companies" to control our lives.
My 2 cents here. Summary: Accutane is dangerous. Do not lie to get it. Do not take it if you cannot take it as directed. Don't practice medicine without a license.
Update later on Jan 21:
Got feedback that included one person's saying:
If by [take] "as directed" you mean with a course of contraceptives, then no, I would not take it as directed. I could sign my name to a lie with no qualms. I answer to a higher power than the medical community. You may not consider that "honorable". C'est la vie.Wow! No qualms about a lie...plus no scruples about telling a lie to someone that would cause him/her to commit malpractice (whether or not civilly actionable.)
My response:
Christine asks: How about, "My two methods of birth control are abstaining, with NFP as a backup?" They don't specify that you have to sign on to two ARTIFICIAL methods of birth control.On that sort of a note, I learned earlier this week that a position in our agency for which I strongly considered applying (even though I really like my current job), a position that fit perfectly with my degrees, expertise, etc., was being changed. Instead of being a Child Health Nurse Consultant (what I did in NC for 8 years), the position now will be almost exclusively "family planning." I took it as further affirmation that I should stay where I am, and was grateful that I hadn't gotten my hopes up for a position that would now involve violating my beliefs. My "potential future boss" agreed.
The iPLEDGE site allowes for complete abstinence, but not for NFP, which it considers to be an "Unacceptable Form of Contraception" (p.19) (their words; don't shoot the messenger!!)
They also state: Abstinence. For this program, all female patients of childbearing potential must fully commit to pregnancy prevention. Abstinence without appropriate contraception is not recommended for patients in the iPLEDGE program who are or have been sexually active. Abstinence may be appropriate when it is a lifestyle choice (e.g., religious practice) and not just a social circumstance (e.g., not having a current partner). If, after counseling, a sexually active patient chooses abstinence without contraception, she must understand that isotretinoin is not recommended for any female patient of childbearing potential who cannot or will not follow the contraceptive requirements of the iPLEDGE program. All female patients of childbearing potential must receive contraception counseling.
This does allow for abstinence for women willing to commit to pre-marital chastity or TOTAL marital continence. The latter is not easy, and may not be reliable, given the extended periods (pun intended) over which therapy may last. Recall that Catholic spouses who commit to NFP are also commanded by their wedding vows to "embrace" the children that God sends. I would not think that this would allow for spouses to "fully commit to pregnancy prevention."
Accutane and the other versions of isotretinoin are only available from providers who are willing to meet all program guidelines, including enrolling patients in the iPLEDGE program, doing all mandatory counseling and testing; it can only be dispensed by pharmacies willing to provide the same counseling.
Your doctor, who also watches "House," knows that "everybody lies." Sadly, some Catholics have proven Dr. House correct.
There are plenty of other Black Box Warning drugs out there--I've taken one for 18 months or so, but only by being willing to follow the rules. Some of the requirements have been a major hassle, but I would never take it were I required to agree to (or pretend to agree to) a practice violating my beliefs. That's not any sort of self-righteousness; I hate the prospect of splitting hairs over degrees of when it is and is not OK to be untruthful...it's easier just to not pretend.
Posts
6 comments:
Crossing the street is dangerous. Flying is dangerous. Immunizations are dangerous. Eating cookie dough is dangerous. Life is a series of calculated risks. If accutane is dangerous, it's hardly unique.
Yes, anonymous, but that doesn't mean you should juggle chainsaws. You also shouldn't get pregnant while you're having radiation therapy or chemo, I'm told.
I seem to remember Jesus saying something like It is also written: thou shalt not tempt the LORD thy God.
Yes, anonymous, but that doesn't mean you should juggle chainsaws. You also shouldn't get pregnant while you're having radiation therapy or chemo, I'm told.
I seem to remember Jesus saying something like "It is also written: thou shalt not tempt the LORD thy God."
Got your blog link from a friend...
I just want to say that Accutane totally sucked when I took it, and the whole contraceptives thing is new. I took Accutane prescribed by my "healthcare professional" for two months longer than described in any brochure and care packet. He told me it would be okay. I suffered severely from the over-abundant dosage, and still feel the consequences to this day. Not realizing what had caused the side-effects, my brother took the medication as well and is now having the same side-effects. All along this process, I had to have blood tests every two weeks to prove I wasn't pregnant. I guess you can say Accutane helped me get over my fear of needles. (However, I did not have to sign anything saying I was using birth control.) Anyway, the drug should be outlawed, because 80% of the side-effects hit AFTER you are done with the prescription course and are therefore no longer having regular check-ups with your dermatologist. Anything that stays in your blood stream for up to three years after you have taken it seems a little dangerous to me - and it is danger you don't really see coming.
Yurodivi's point is appropriate on dangers to pregnancies from chemo & radiation; a recent canonization involved an Italian woman who refused treatment for her cancer that would've killed her developing baby. It's not just avoiding the chainsaws; it's choosing life (what amazing courge!)
Heather, you're right that Accutane is a pretty dangerous drug. It's not just the risks to developing infants that make it so; it affects multiple organ systems in similar ways to Vitamin A toxicity (I think it is metabolized in the liver), plus seems to be linked to psychiatric disturbances. See latest FDA patient info here.
I've never suffered from the painful, scarring type of cystic acne for which Accutane was developed; making a choice to use, and keep using, this medication must have been difficult for you. It's likely that demand from users with that level of scarring are what keeps this drug on the market; were there something less toxic, there'd be no demand for this drug. Then we might have to worry less about iPledges to use birth control.
I found this blog as a medical student interested in accutane use in Catholics. We are taught that contraception is required for accutane, but we weren't taught how this is handled for patients who can't take OCPs on moral grounds.
It looks like iPledge now allows an abstinence pledge. I'm glad this has been added, as abstinence should obviously be accepted as effective contraception.
It seems sad, though, that all these hoops are necessary to obtain and use accutane. There are plenty of other drugs on the market just as dangerous, but without invasive, legislated safety. For most drugs, physicians are expected to be competent to explain the risks, so why single out accutane?
Post a Comment