{"id":4598,"date":"2021-09-07T05:11:15","date_gmt":"2021-09-07T03:11:15","guid":{"rendered":"http:\/\/www.infokuryr.cz\/n\/?p=4598"},"modified":"2021-09-07T05:11:15","modified_gmt":"2021-09-07T03:11:15","slug":"nechte-je-zemrit-o-desivych-trendech-v-lekarske-komunite-od-covid-19","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2021\/09\/07\/nechte-je-zemrit-o-desivych-trendech-v-lekarske-komunite-od-covid-19\/","title":{"rendered":"\u201eNechte je zem\u0159\u00edt\u201c: O d\u011bsiv\u00fdch trendech v l\u00e9ka\u0159sk\u00e9 komunit\u011b od COVID-19"},"content":{"rendered":"
<\/div>\n

Toto je zpr\u00e1va l\u00e9ka\u0159e ka\u017ed\u00e9mu, kdo obhajuje odep\u0159en\u00ed l\u00e9ka\u0159sk\u00e9ho o\u0161et\u0159en\u00ed lidem, kte\u0159\u00ed nebyli o\u010dkov\u00e1ni proti COVID-19 nebo kte\u0159\u00ed si o\u010dkov\u00e1n\u00ed nep\u0159ej\u00ed.<\/strong><\/p>\n

Ve Spojen\u00fdch st\u00e1tech, Brit\u00e1nii a \u010d\u00e1stech Evropy se objevil z\u00e1ke\u0159n\u00fd postoj, podporovan\u00fd politiky, odborn\u00edky a – co\u017e je nejv\u00edce znepokojiv\u00e9 – l\u00e9ka\u0159i: \u017ee neo\u010dkovan\u00fdm lidem naka\u017een\u00fdm COVID -19 by m\u011bla b\u00fdt odep\u0159ena l\u00e9ka\u0159sk\u00e1 p\u00e9\u010de.\u00a0<\/span>To by vytvo\u0159ilo nebezpe\u010dn\u00fd precedent\u00a0a rozbilo z\u00e1kladn\u00ed principy l\u00e9ka\u0159sk\u00e9 praxe v j\u00e1dru.<\/span><\/p>\n

B\u00fdval\u00e1 americk\u00e1 sen\u00e1torka za Missouri Claire McCaskillov\u00e1 po\u017eaduje zv\u00fd\u0161en\u00ed pojistn\u00e9ho u neo\u010dkovan\u00fdch.\u00a0Piers Morgan, britsk\u00e1 televizn\u00ed osobnost, po\u017eaduje na sv\u00e9m twitterov\u00e9m \u00fa\u010dtu, kter\u00fd sleduje t\u00e9m\u011b\u0159 osm milion\u016f lid\u00ed, aby britsk\u00fd zdravotnick\u00fd syst\u00e9m odm\u00edtl hospitalizovan\u00e1 l\u016f\u017eka neo\u010dkovan\u00fdm.\u00a0Nouzov\u00fd l\u00e9ka\u0159 z Arizony odpov\u011bd\u011bl \u201eNechte je zem\u0159\u00edt\u201c na videoklip zve\u0159ejn\u011bn\u00fd na soci\u00e1ln\u00edch s\u00edt\u00edch, kde jsou v obchod\u011b s potravinami lid\u00e9 bez rou\u0161ek.\u00a0Chirurg z Massachusetts navrhuje, aby l\u00e9ka\u0159i na pacientovo odm\u00edtnut\u00ed vakc\u00edny COVID-19 obecn\u011b pohl\u00ed\u017eeli jako na instrukci \u201eneintubovat \/ neresuscitovat\u201c.<\/span><\/p>\n

Nejedn\u00e1 se o soukrom\u00e9 my\u0161lenky nebo konverzace mezi kolegy: jsou to v\u00fdzvy k akci, sd\u00edlen\u00e9 na soci\u00e1ln\u00edch m\u00e9di\u00edch, adresovan\u00e9 ve\u0159ejnosti.\u00a0A to by n\u00e1s m\u011blo vyd\u011bsit.<\/span><\/p>\n

Primum non nocere: Za prv\u00e9, neubli\u017eujte<\/span><\/strong><\/p>\n

L\u00e9ka\u0159i ji\u017e tyto verb\u00e1ln\u00ed \u00fatoky uv\u00e1d\u011bj\u00ed do praxe.\u00a0Florid\u0161t\u00ed zdravotn\u00edci uspo\u0159\u00e1dali varovn\u00fd \u00fader frustrovan\u00fd z toho, \u017ee se jejich nemocnice zaplnily pacienty s COVID-19.\u00a0Pracovn\u00ed skupina pro COVID-19 v Texasu byla donucena st\u00e1hnout n\u00e1vrh na p\u0159id\u011blen\u00ed l\u016f\u017eek na JIP sp\u00ed\u0161e na z\u00e1klad\u011b stavu o\u010dkov\u00e1n\u00ed ne\u017e pot\u0159eby.\u00a0Rodinn\u00fd l\u00e9ka\u0159 v Alabam\u011b se roze\u0161el se v\u0161emi pacienty, kte\u0159\u00ed se rozhodli proti o\u010dkov\u00e1n\u00ed, a\u0165 u\u017e byli nemocn\u00ed nebo ne.<\/span><\/p>\n

L\u00e9ka\u0159sk\u00e1 komunita na Z\u00e1pad\u011b je na pokraji etick\u00e9ho pochyben\u00ed a v z\u00e1jmu sou\u010dasnosti a budoucnosti pacient\u016f mus\u00edme ud\u011blat krok zp\u011bt a pamatovat si, pro\u010d d\u011bl\u00e1me svou pr\u00e1ci zdravotnick\u00fdch profesion\u00e1l\u016f.<\/span><\/p>\n

Z\u00e1kladn\u00ed z\u00e1sadou l\u00e9ka\u0159sk\u00e9 praxe je neubli\u017eovat pacientovi, latinsky primum non nocere – zaprv\u00e9 neubli\u017eovat.\u00a0Americk\u00fd prezident Joe Biden v televizn\u00edm projevu 2. \u010dervna tohoto roku \u0159ekl o t\u0159ech dostupn\u00fdch vakc\u00edn\u00e1ch proti COVID -19: \u201eSe\u010dteno a podtr\u017eeno – a slibuji v\u00e1m, \u017ee vakc\u00edny jsou bezpe\u010dn\u00e9. Jsou bezpe\u010dn\u00e9.\u201c\u00a0Tato zpr\u00e1va byla nesporn\u011b zopakov\u00e1na nes\u010detn\u00fdmi v\u00e1\u017en\u00fdmi m\u00edsty, od nemocni\u010dn\u00edch spr\u00e1v objedn\u00e1vaj\u00edc\u00edch o\u010dkov\u00e1n\u00ed zam\u011bstnanc\u016f pro profesn\u00ed organizace: \u201eVakc\u00edna je bezpe\u010dn\u00e1\u201c.<\/span><\/p>\n

Aby bylo jasno: V\u011b\u0159\u00edm, \u017ee o\u010dkov\u00e1n\u00ed je jednou z nejd\u016fle\u017eit\u011bj\u0161\u00edch terapeutick\u00fdch novinek v historii medic\u00edny.\u00a0Vakc\u00edny zachr\u00e1nily miliony a miliony \u017eivot\u016f.\u00a0P\u0159esto se domn\u00edv\u00e1m, \u017ee tyto vakc\u00edny proti COVID-19 s jejich nov\u00fdmi mechanismy \u00fa\u010dinku byly ve\u0159ejnosti p\u0159edstaveny jako v\u0161el\u00e9k a jste \u201eidiot, pokud je odm\u00edtnete\u201c, jako \u201eh\u0159eb\u00edk do rakve koronaviru\u201c, co\u017e je neup\u0159\u00edmn\u00e9, p\u0159ehnan\u00e9 a jednodu\u0161e to nen\u00ed od\u016fvodn\u011bno dostupn\u00fdmi \u00fadaji.<\/span><\/p>\n

Existuj\u00ed ur\u010dit\u00e9 d\u016fkazy, \u017ee st\u00e1vaj\u00edc\u00ed vakc\u00edny proti COVID-19 nemus\u00ed b\u00fdt zcela bezpe\u010dn\u00e9 pro v\u0161echny pacienty.\u00a0VAERS (Vaccine Adverse Event Reporting System) – americk\u00e1 vl\u00e1dn\u00ed agentura pro hl\u00e1\u0161en\u00ed ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f l\u00e9\u010div – nazna\u010duje, \u017ee ne\u017e\u00e1douc\u00ed vedlej\u0161\u00ed \u00fa\u010dinky jsou extr\u00e9mn\u011b vz\u00e1cn\u00e9, ale p\u0159\u00edznaky jako ochrnut\u00ed obli\u010deje, z\u00e1n\u011bt srde\u010dn\u00edho svalu, krevn\u00ed sra\u017eeniny a dokonce smrt.\u00a0 To je v\u0161ak do zna\u010dn\u00e9 m\u00edry zam\u00edtnuto z toho d\u016fvodu, \u017ee z\u00e1znam VAERS o p\u0159\u00edpadech s vedlej\u0161\u00edmi \u00fa\u010dinky nem\u016f\u017ee uk\u00e1zat \u017e\u00e1dnou p\u0159\u00ed\u010dinnost o\u010dkov\u00e1n\u00ed a \u017ee hl\u00e1\u0161en\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky jsou individu\u00e1ln\u00edmi p\u0159\u00edpady-jako u\u00a0\u00a0<\/span>44let\u00e9ho<\/span><\/em>\u00a0moder\u00e1tora\u00a0BBC,<\/em> kter\u00fd kr\u00e1tce pot\u00e9 informoval o o\u010dkov\u00e1n\u00ed a zem\u0159el.<\/span><\/p>\n

Ne\u017e\u00e1douc\u00ed \u00fa\u010dinky l\u00e9ku je t\u0159eba pe\u010dliv\u011b prozkoumat<\/span><\/strong><\/p>\n

Drogov\u00e1 terapie, zejm\u00e9na nov\u00e1, v\u0161ak nesm\u00ed b\u00fdt pova\u017eov\u00e1na za \u201enevinnou, dokud se neprok\u00e1\u017ee vina\u201c.\u00a0Sp\u00ed\u0161e je t\u0159eba d\u016fkladn\u011b a form\u00e1ln\u011b prozkoumat v\u0161echny mo\u017en\u00e9 ne\u017e\u00e1douc\u00ed vedlej\u0161\u00ed \u00fa\u010dinky l\u00e9\u010diva, proto\u017ee zp\u016fsoben\u00e1 \u0161koda je n\u011bkdy hor\u0161\u00ed, ne\u017e se o\u010dek\u00e1valo, jak objevila farmaceutick\u00e1 spole\u010dnost Merck na po\u010d\u00e1tku roku 2000 se schv\u00e1len\u00fdm prost\u0159edkem proti bolesti Vioxx.\u00a0V\u00fdzkum publikovan\u00fd v l\u00e9ka\u0159sk\u00e9m \u010dasopise\u00a0<\/span>\u00a0The Lancet<\/span><\/em> \u00a0odhadoval, \u017ee 88 000 Ameri\u010dan\u016f utrp\u011blo infarkt p\u0159i u\u017e\u00edv\u00e1n\u00ed p\u0159\u00edpravku Vioxx a 38 000 z nich zem\u0159elo.<\/span><\/p>\n

V sou\u010dasn\u00e9 dob\u011b neexistuje \u017e\u00e1dn\u00fd d\u016fkaz, \u017ee by o\u010dkov\u00e1n\u00ed proti COVID-19 bylo t\u00e9m\u011b\u0159 stejn\u011b nebezpe\u010dn\u00e9.\u00a0Obecn\u00e1 negace jejich potenci\u00e1ln\u00edch nebezpe\u010d\u00ed ze strany l\u00e9ka\u0159sk\u00e9 komunity, a\u017e do ulo\u017een\u00ed pravidel o\u010dkov\u00e1n\u00ed mlad\u00fdm a zdrav\u00fdm populac\u00edm, jako je americk\u00e1 arm\u00e1da, je zradou z\u00e1sady primum non nocere a bude st\u00e1t \u017eivoty.<\/span><\/p>\n

\u017d\u00e1dn\u00e1 l\u00e9\u010debn\u00e1 terapie nen\u00ed bez rizika, ale informovan\u00fd souhlas – dal\u0161\u00ed z\u00e1kladn\u00ed princip medic\u00edny – vy\u017eaduje, aby byl pacient informov\u00e1n i o t\u011bch nejmen\u0161\u00edch rizic\u00edch.\u00a0Mal\u00e9 procento osob posti\u017een\u00fdch vedlej\u0161\u00edmi \u00fa\u010dinky nen\u00ed zanedbateln\u00e9 \u010d\u00edslo.\u00a0Podle VAERS je nejm\u00e9n\u011b 6000 \u00famrt\u00ed v d\u016fsledku dobrovoln\u00e9ho o\u010dkov\u00e1n\u00ed proti COVID-19 dvakr\u00e1t tolik ob\u011bt\u00ed ne\u017e \u00famrt\u00ed z \u00fatok\u016f z 11. z\u00e1\u0159\u00ed.\u00a0N\u011bco takov\u00e9ho nelze jednodu\u0161e opr\u00e1\u0161it argumentem \u201estatistick\u00e9 bezv\u00fdznamnosti\u201c.<\/span><\/p>\n

V asi nejnezodpov\u011bdn\u011bj\u0161\u00edm p\u0159\u00edpad\u011b zanedb\u00e1n\u00ed rizika Americk\u00fd porodnick\u00fd a gynekologick\u00fd institut a Spole\u010dnost pro \u017eenskou a fet\u00e1ln\u00ed medic\u00ednu objasnily, \u017ee \u201eo\u010dkov\u00e1n\u00ed je bezpe\u010dn\u00e9 p\u0159ed t\u011bhotenstv\u00edm, b\u011bhem n\u011bj nebo po n\u011bm\u201c, p\u0159i\u010dem\u017e dob\u0159e v\u011bd\u011blo, \u017ee neexistuj\u00ed \u017e\u00e1dn\u00e9 dlouhodob\u00e9 studie a existuj\u00ed data na podporu tohoto tvrzen\u00ed.<\/span><\/p>\n

V medic\u00edn\u011b existuje mnoho okolnost\u00ed, kdy zanedbateln\u00e9 riziko st\u00e1le vede k drastick\u00fdm opat\u0159en\u00edm.\u00a0Ka\u017ed\u00fd anesteziolog zahrne do sv\u00e9ho p\u0159edopera\u010dn\u00edho rozhovoru s pacientem riziko srde\u010dn\u00edho z\u00e1chvatu nebo c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody, bez ohledu na to, kolik tis\u00edc jednotv\u00e1rn\u00fdch anestetik podal.\u00a0L\u00e9ka\u0159i se historicky zab\u00fdvaj\u00ed zanedbateln\u00fdm rizikem a vyvinuli spole\u010dn\u00e9 \u00fasil\u00ed, aby pacienta p\u0159im\u011b\u0159en\u011b informovali a chr\u00e1nili.\u00a0Na\u0161e spole\u010dn\u00e9 selh\u00e1n\u00ed ud\u011blat tot\u00e9\u017e v p\u0159\u00edpad\u011b nov\u00fdch vakc\u00edn proti COVID-19 je nemilosrdn\u00e9 a matouc\u00ed.<\/span><\/p>\n

Pe\u010dujte podle pot\u0159eby, ne podle z\u00e1sluh<\/span><\/strong><\/p>\n

Dalo by se nam\u00edtnout, \u017ee toto chov\u00e1n\u00ed neohro\u017euje ostatn\u00ed, na rozd\u00edl od nedostate\u010dn\u00e9 ochrany p\u0159ed p\u0159enosnou nemoc\u00ed.\u00a0Pokud pomineme skute\u010dnost, \u017ee vakc\u00edny proti COVID-19 nesterilizuj\u00ed nebo nejsou zabezpe\u010deny proti p\u0159enosu, pou\u017eijeme tento standard na homosexu\u00e1ly s AIDS?\u00a0Nitro\u017eiln\u00edm u\u017eivatel\u016fm drog s hepatitidou C?\u00a0Sexu\u00e1ln\u00ed pracovnice se sexu\u00e1ln\u011b p\u0159enosn\u00fdmi chorobami?\u00a0Opil\u00fdm \u0159idi\u010d\u016fm, kte\u0159\u00ed zp\u016fsob\u00ed smrteln\u00e9 dopravn\u00ed nehody?\u00a0Jakmile se zdravotn\u00ed sestry h\u00e1daj\u00ed, kdo si zaslou\u017e\u00ed l\u00e9\u010dbu a kdo ne, ji\u017e neexistuje z\u00e1sada, kter\u00e1 omezuje takov\u00e9 sebeur\u010den\u00ed na \u201epouze neo\u010dkovan\u00e9 pacienty s COVID-19 a pouze do doby, ne\u017e pandemie skon\u010d\u00ed\u201c.\u00a0Je to d\u011bsiv\u00e1 vyhl\u00eddka.<\/span><\/p>\n

Pro l\u00e9ka\u0159e, sestry a v\u0161echny osoby zapojen\u00e9 do l\u00e9ka\u0159sk\u00e9 p\u00e9\u010de je to, co mus\u00edme ud\u011blat, jednoduch\u00e9: o\u0161et\u0159it pacienta.\u00a0O\u0161et\u0159ete vaskul\u00e1rn\u00edho pacienta, kter\u00fd dost\u00e1v\u00e1 \u0161est\u00fd srde\u010dn\u00ed bypass a st\u00e1le kou\u0159\u00ed dv\u011b krabi\u010dky cigaret denn\u011b.\u00a0O\u0161et\u0159ete pacientku chronickou bolest\u00ed, kter\u00e1 v\u00e1\u017e\u00ed t\u0159ikr\u00e1t v\u00edce, ne\u017e jej\u00ed kostra unese.\u00a0O\u0161et\u0159ov\u00e1n\u00ed \u010dlena gangu, kter\u00fd si zlomil z\u00e1p\u011bst\u00ed p\u0159i pokusu o \u00fat\u011bk p\u0159ed polici\u00ed, narazil sv\u00fdm autem do auta p\u011bti\u010dlenn\u00e9 rodiny a \u010dty\u0159i z nich zabil. O\u0161et\u0159ete opilce, kter\u00fd je opakovan\u011b sp\u011bch\u00e1\u00a0na pohotovost.\u00a0O\u0161et\u0159ete mu\u017ee, kter\u00fd si do kone\u010dn\u00edku vlo\u017eil baterku, natolik, aby vy\u017eadoval chirurgick\u00fd z\u00e1krok.\u00a0Chovejte se ke ka\u017ed\u00e9mu se stejnou vynikaj\u00edc\u00ed p\u00e9\u010d\u00ed,\u00a0to by bylo nab\u00eddnuto komukoli jin\u00e9mu, neo\u010dkovan\u00e9mu i o\u010dkovan\u00e9mu.\u00a0Dosud jsem tak \u010dinil a budu v tom pokra\u010dovat.<\/span><\/p>\n

Poskytujeme p\u00e9\u010di na vy\u017e\u00e1d\u00e1n\u00ed, nikoli podle vlastn\u00edch podm\u00ednek, kdo si to zaslou\u017e\u00ed.\u00a0Zat\u0159esme hlavou nad mlhou frustrace, kter\u00e1 se zvedla v d\u016fsledku pandemie COVID-19.\u00a0Vzpome\u0148me si, pro\u010d jsme si vybrali toto nevd\u011b\u010dn\u00e9, obt\u00ed\u017en\u00e9 a \u010destn\u00e9 povol\u00e1n\u00ed.\u00a0Ud\u011blejme svoji pr\u00e1ci.<\/span><\/p>\n

A pokud to nem\u016f\u017eete ud\u011blat, ud\u011blejte pros\u00edm n\u011bco jin\u00e9ho.<\/span><\/p>\n

RM Huffman je l\u00e9ka\u0159, spisovatel a kulturn\u00ed pozorovatel<\/span><\/em><\/p>\n

\"\"<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Toto je zpr\u00e1va l\u00e9ka\u0159e ka\u017ed\u00e9mu, kdo obhajuje odep\u0159en\u00ed l\u00e9ka\u0159sk\u00e9ho o\u0161et\u0159en\u00ed lidem, kte\u0159\u00ed nebyli o\u010dkov\u00e1ni proti…<\/p>\n","protected":false},"author":2,"featured_media":3997,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[593,677,1155],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/4598"}],"collection":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/comments?post=4598"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/4598\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/3997"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=4598"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=4598"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=4598"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}