I want to share my perspective as an infectious disease practitioner who cares for patients with these infections regularly. As I have mentioned more privately, there are cultural issues driving the emergence of resistance, especially in the U.S., first with MRSA, then VRE, and now with CRE. Warning: my observations may not be politically correct—but they reflect 30+ years of patient care. These include:
— The belief many have that people will live forever. There used to be more of an acceptance of death. But with television/movies portraying advances in medicine unrealistically, the public now often has an expectation that their loved ones will not die. Some seem to feel that any death must be a result of medical error, and there are a number of malpractice attorneys vying for their attention with aggressive advertising reinforcing that belief.
— Pharmaceutical companies and their sales reps push doctors to use the latest wonder drugs. If a physician uses older agents, s/he is likely to be portrayed as not keeping up to date with medical advances.
— Individual “rights” above all. Physicians and families focus on the possible benefit for one patient, with little or no concern as to public health implications of treatment. This sounds harsh, but should we reconsider treatment of nonviable patients for the good of the community. This warrants thoughtful discussion.I really appreciate her observations about the cultural attitudes and corporate values that drive health care, especially here in North America. Until we can look at ourselves with some detachment, we will experience more unintended consequences of our own actions.