In the middle of the current tsunami of financial catastrophes the question of”moral hazard” has been increased to describe the way the banks, which have made quite wrong investment choices, have been insulated in their damaging consequences by government bailouts and rescue packages. Not allowing banks to fail as a result of their ridiculous mistakes insulates them from the negative comments which may better correct their behavior later on.
Hazard
So how can the moral hazard of rescuing poor banks employ to HRT? This: that the separation between actions and consequences, especially if the consequences are delayed for many years and occur somewhat randomly, and the”rescue” from consequences are the hallmarks of moral hazard, and they apply to medicine in addition to banking.
There’s no longer any debate among scientists about whether HRT is associated with an increased risk of cancer: it’s. If HRT contains only estrogen, then there is an increased risk for esophageal cancer. If HRT comprises progesterone, then there’s a heightened risk for breast cancer.
Risks
Furthermore, all types of HRT are associated with a greater risk for stroke and blood clots. This is not an issue of how the hormones are created (from artificial or natural products) but rather what they do. And what they do to the post-menopausal female is “unnatural” in the context of an otherwise obviously aging body. We know that there’s a higher risk of breast cancer in the group of women who use HRT, but we don’t know precisely which of those women will find the cancer.
It’s important to see that we just know the numbers for the group; we don’t know precisely who will find the disease, and whether the hormones are responsible for it. The medical and ethical hazard associated with HRT is enlarged by the medical system “safety net” – the remedies which are available once among the complications of HRT occurs.
Did You Know?
Today early treatment of breast cancer generates excellent survival numbers for many patients, but it’s not possible to say precisely who will live and who will die of breast cancer since figures apply to a group, not to a single patient. The current discussion of HRT provided by Oprah Winfrey in her magazine and on her TV show presents both sides of the debate about HRT, but does little to settle the question.
In the end women are counseled to “talk to their physician.” As a woman, and as a breast cancer surgeon, I’m concerned that countless women will come away from Oprah’s show with the belief that HRT might not be so risky after all. I disagree. HRT is insecure; the issue is we can’t say exactly for whom it’s risky. Do you wish to take the risk that the bell tolls for you? You say you can’t sleep at night. How much more sleep do you believe you will lose if you’re told you have breast cancer? How much sleep will you loose fretting about how to cover all your treatments?