Two pieces of medical news caught my eye this past week.
First, according to the New York Times, physicians at the highly-respected University of Pittsburgh Medical Center are going to start putting selected patients to death. Not through improper care, but on purpose.
The idea is that patients who come into the emergency room on the brink of death because of a life-threatening injury will occasionally have all of their blood replaced with freezing salt water. That means their hearts will stop beating and their brains will stop working. They’ll be dead.
This will be done in order to give surgeons more time to do their job. Instead of having a few minutes to address the gunshot wound or other injury, they may have up to an hour to operate before the patient suffers brain damage. The medical staff will then resuscitate the patient by replacing the cold salt water with nice warm blood.
This procedure has been successfully used on animals like pigs and dogs, but never before on a person. The hospital is planning to perform Emergency Preservation and Resuscitation (EPR) about once a month for a couple of years before reaching a decision on its effectiveness.
One might think that killing your patient is a clear violation of the medical maxim: “first, do no harm” (primum non nocere). But since the patients in question will already be in cardiac arrest, and very likely to die anyway, and since the kind of death they’ll suffer is expected to be temporary and should give them a much better chance of surviving their injury, it isn’t clear that the doctors will be harming anyone, at least in the usual sense.
Perhaps a more troubling issue is that patients being subjected to this kind of procedure won’t be in a position to give their consent. They’ll already be unconscious. So the medical center has publicized this new procedure in and around Pittsburgh and given prospective patients the opportunity to opt out if they choose. But the default setting in case you’re ever shot or stabbed in western Pennsylvania and end up in the UPMC emergency room will be to receive EPR (and possibly meet your maker), if you are a suitable candidate.
The other news that caught my eye is that researchers in England claim to have come up with a new treatment for tooth decay. The procedure is called Electrically Accelerated and Enhanced Remineralisation (EAER). Dentists will use a very small electrical current to accelerate “the natural movement of calcium and phosphate minerals into the damaged tooth”. In effect, your tooth will heal itself with some encouragement from your dentist. The procedure wouldn’t require an anesthetic, drilling or a filling (and dentists would become more popular people).
It isn’t clear from the article in the Guardian how long it will take to fix a cavity this way. In an ideal world, your cavities could be repaired through EAER at the same time your gunshot wound was repaired through EPR. But that probably won’t be possible for a few years yet.