The 1944 film classic, Arsenic and Old Lace, featured the rapid death of several elderly men after drinking arsenic-flavored elderberry. The film embodies the popular belief that arsenic is still a deadly, fast-acting poison. In fact, the sudden deaths depicted in the film were not due to arsenic, but to strychnine and cyanide, which were also added to the wine cocktail.
"Manifestations of arsenic poisoning are generally not acute," writes Dr. Robert E. Gallagher in the New England Journal of Medicine. However, he adds that “arsenic poisoning from contaminated drinking water and industrial contaminants is a serious public health problem in many parts of the world, predisposing people to various diseases such as the skin, bladder, lungs and liver. Cancer ".
Based on the above information, it is understandable that health professionals generally do not consider prescribing arsenic as a form of treatment. But follow this Canadian experience closely. Notice how a conflict of conscience developed between a patient named Darlene and her doctors, nurses, and pharmacists involved when blood transfusions and then arsenic were suggested as treatments. Darlene tells her story this way.
“In May 1996, I had problems with severe bruising, bleeding, and unusual bleeding gums. My hematologist Dr. John Matthews of Kingston, Ontario diagnosed the problem as a rare type of cancer known as acute promyelocyte leukemia (APL). After a series of tests, including a bone marrow diagnosis, Dr. Matthews kindly explains what APL is and how it is handled. The normal treatment protocol included blood exchanges with chemotherapy, but my biblical conscience did not allow me to accept blood transfusions.
Instead of wasting valuable time changing his mind, doctors wisely looked for other medical treatments. The modified treatment included the use of a vitamin A derivative in combination with moderately intense chemotherapy. My leukemia went into remission for three months and then came back in full force. The headache caused by the swelling of the brain was unbearable. In addition, he developed resistance to the treatment. At that point the doctor informed us that without a blood transfusion there would be no treatment for me. They told us I was less than two weeks old.
“The following days were filled with more blood tests, visits to the lawyer about my will, and funeral arrangements. During this time, Dr. Matthews of an unusual medical therapy that has been successfully used for APL by doctors in China and that has been featured in respected scientific journals such as the National Academy of Sciences' Blood and Proceedings. During the investigation, the doctor and a colleague read in a medical journal: “Many will probably be surprised that arsenic trioxide has been used successfully intravenously and with limited toxicity to treat leukemia. acute promyelocyte cell (APL). . '
“Now there were two options: violating my conscience and accepting a blood transfusion, or doing this treatment with little-known arsenic. I chose arsenic treatment. * I failed to realize the confusion of conscience that would affect doctors, nurses, pharmacists, and even hospital workers.
“The hospital then asked the regulatory authorities whether arsenic trioxide could be administered. Only then could they continue this treatment. Initially, the pharmacist was reluctant to cooperate because he carefully questioned his safety. My treating doctors, Dr. Matthews and Dr. Galbraith, must have made convincing and positive presentations about this treatment. Finally, when sufficient medical evidence was presented to support the treatment, the hospital officials and pharmacist felt they could work together.
“The pharmacist agreed to prep the product with arsenic and sterilize it for immediate infusion. But now the nurses' collective conscience would not allow them to hang up the intravenous bag of the controversial substance. They remained immobile while the doctors suspended several units of the solution. The nurses asked me to draw blood. They were convinced that I was going to die, so I appealed to their professionalism and asked them to respect my conscientious rejection of blood. I thanked them, put my arm around them, and asked them to put aside their personal feelings. We had a good relationship. The treatment with arsenic trioxide lasted six months and I made a good recovery. The doctors then agreed that he could do the rest of the treatments at home.
“Home visit arrangements have been made with the Victorian College of Nurses, which administers the home care services. Once again the subject of conscience came up. They also hesitated to give the solution. Meetings, letters, and medical articles from respected medical journals made the difference. The nurses then agreed to work together. In September 1997 I finished my treatments.
“Oh yes, my cancer can come back. The doctor says it's like living with a time bomb. But I learned to find joy every day, never to leave my place of worship and to be busy sharing the biblical hope of a time when “no resident will say: I am sick. .
Healthcare professionals have a major responsibility to provide quality health care. As a rule, they take this seriously and carry out the treatment conscientiously within the framework of their current knowledge and experience. As this experience shows, doctors, nurses, and other health professionals can achieve much by remaining flexible and receptive to the beliefs and conscience of the informed adult patient.