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How Corporate Health Care Leaders Maintain Their Impunity: The Case of Purdue Pharma's Funding of the Washington Legal Foundation to Attempt to Weaken the Responsible Corporate Officer Doctrine

The ongoing epidemic of narcotic (opioid) abuse, and the resulting rise in the deaths due to overdoses, has focused attention on pharmaceutical companies' aggressive promotion of these drugs which minimized their substantial risk. A recent article in the Intercept showed how the leadership of one such company tried to insulate itself from responsibility for such actions even while such promotions were continuing. Background: Impunity of Top Leaders of Big Health Care Organizations For years, we have railed against the impunity of top leaders of health care organizations.  We have noted that despite numerous legal settlements made by health care organizations of alllegations like fraud , bribery , and kickbacks , almost never do top leaders who presided over these actions face any negative consequences.  Lack of deterrence caused by such impunity appears to be a major cause of  the epidemic of continuing unethical behavior, crime and corruption on the part of large health car

Health Care and COPD

COPD is a debilitating disease that affects your ability to breathe well. COPD, or chronic obstructive pulmonary disease, is a lung condition usually caused by smoking. It affects more than 24 million people in the U.S., or 6 percent of the population as of 2013. It is the third leading cause of death in America.

According to the COPD Foundation, Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness. Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms.

COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you notice any of these symptoms. Ask your doctor about taking a spirometry test.  What are the symptoms?

·         Increased breathlessness
·         Frequent coughing (with and without sputum)
·         Wheezing
·         Tightness in the chest.

Most cases of COPD are caused by inhaling pollutants; that includes smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke. Fumes, chemicals and dust found in many work environments are contributing factors for many individuals who develop COPD. Genetics can also play a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.  See more at: http://www.copdfoundation.org/ .

Additionally, COPD is a serious and progressive lung disease that can make it difficult to breathe and get enough oxygen into the body. Normally, air flows into the lungs via the nose, mouth, and air tubes (airways) leading to the lungs. In the lungs, oxygen (O2) from the air passes through air sacs and into blood vessels, which carry the oxygen to all parts of the body. At the same time, carbon dioxide (CO2) passes out of the blood vessels into the air sacs and is blown out of the lungs when you exhale, according to the American College of Chest Physicians.

COPD is made up of two diseases that obstruct, or block, the normal flow of air and oxygen. Emphysema damages the airways and air sacs, making it difficult for the body to effectively exchange oxygen and carbon dioxide. Chronic bronchitisis characterized by swollen and inflamed airways that produce large amounts of mucus. The inflammation and mucus narrow the airways, making it difficult for air and oxygen to flow freely through the body. Many people with COPD have a combination of emphysema and chronic bronchitis. Some also have asthma-like symptoms or reactive airway disease.

COPD is a progressive disease, which means that it can get worse over time. But proper treatment can control the disease and its symptoms, making it easier for you to breathe and enjoy life. You can work with your health-care provider to learn ways to improve your breathing and fitness and prevent quick and serious worsening of your disease. It IS possible to live well with COPD.  More details can be found at this site: http://www.chestnet.org/Foundation/Patient-Education-Resources/COPD .

According to the American Thoracic Society, when symptoms first occur, most people ignore them as they think that they are related to smoking, i.e. "It’s just a smoker’s cough" or "I’m just winded/breathless from being out of shape". These symptoms can worsen to the point that people are motivated to stop smoking in order to control the symptoms. Others let the symptoms control them.

These signs and symptoms of COPD (breathlessness, tiredness, cough and sputum production) are an indication that the lungs are not normal, even though the lungs are actually responding "normally" to the irritation. Many people with COPD develop most, if not all, of these signs and symptoms. More detailed material can be also found at this website: http://www.thoracic.org/clinical/copd-guidelines/for-patients/what-are-the-signs-and-symptoms-of-copd.php .

The American Lung Association additionally has many valuable resources for anyone who may be diagnosed with COPD. You can learn more at their website for this disease: http://www.lung.org/lung-disease/copd/ .

More than 50% of adults with low pulmonary function were not aware that they had COPD; therefore the actual number may be higher, according to the Centers for Disease Control (CDC). The following groups were more likely to report COPD:

·         People aged 65–74 years.
·         Non-Hispanic whites.
·         Women.
·         Individuals who were unemployed, retired, or unable to work.
·         Individuals with less than a high school education.
·         People with lower incomes.
·         Individuals who were divorced, widowed, or separated
·         Current or former smokers.
·         Those with a history of asthma.

Treatment of COPD requires a careful and thorough evaluation by a physician. COPD treatment can alleviate symptoms, decrease the frequency and severity of exacerbations, and increase exercise tolerance. For those who smoke, the most important aspect of treatment is smoking cessation. Avoiding tobacco smoke and removing other air pollutants from the patient’s home or workplace are also important. Symptoms such as coughing or wheezing can be treated with medication, according to the CDC.

Pulmonary rehabilitation is an individualized treatment program that teaches COPD management strategies to increase quality of life. Plans may include breathing strategies, energy-conserving techniques, and nutritional counseling. The flu can cause serious problems in people with COPD.

Vaccination during flu season is recommended and respiratory infections should be treated with antibiotics, if appropriate. Patients who have low blood oxygen levels are often given supplemental oxygen. More material on this health care topic can be found at this website: http://www.cdc.gov/copd/ .

If you feel that you may be experiencing breathing issues or other symptoms that could be COPD, make sure you contact your family doctor or a professional medical provider that can begin testing you for this disease. Since the disease can be fatal if not properly treated, it is always in your best interest to seek health care advice at the earliest possible opportunity.

Until next time.

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