March 25, 2020
By Naomi Lopez and Christina Sandefur
Nevada Governor Steve Sisolak is a politician and a businessman, but now, he’s playing coronavirus doctor from his perch in Carson City: Governor Sisolak has banned the use of a drug, chloroquine, for the treatment of COVID-19 in the state.
While it is true that President Trump recently misspoke when he said chloroquine and its newer formulation, hydroxychloroquine, were federally approved to treat COVID-19, these drugs are FDA-approved – and it’s perfectly legal for doctors to prescribe them. In fact, both the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) are sharing information and facilitating the use and clinical evaluation of this drug as a possible virus treatment.
Prescribing medicines to treat conditions other than what the FDA approved that medicine to treat—called “off-label uses”—is legal and common. In fact, roughly 20 percent of all prescriptions are off-label—such as when treatments are prescribed for children although they’ve only been FDA-evaluated for adults. Chloroquine and hydroxychloroquine are FDA-approved to treat malaria, lupus, and rheumatoid arthritis. The FDA has yet to approve a treatment for COVID-19 – but doctors can lawfully prescribe any approved medication that, in their medical judgment, they determine could help their patient. Indeed, they are ethically obligated to do so.
Of course, there are legitimate concerns about prescribing the drug for people who are not sick but just want to stockpile it. That threatens the supply for lupus and arthritis patients, as well as patients whose physicians believe they may benefit from using the drug off-label. But the answer isn’t to make prescribing the drug illegal—especially during a pandemic. Lawmakers can use other tools to address temporary issues with supply, as Governor Sisolak has already done by limiting prescription fills to 30 days. But they should never replace a doctor’s medical judgment with their own.
As we face this unprecedented healthcare crisis, we must never lose sight of fundamental principles—principles that matter now more than ever. One of the bedrock principles of medical ethics is autonomy: Decisions about healthcare are ultimately for the doctor and patient to make, because it is ultimately the patient’s life that hangs in the balance—not the government’s.
Politicians aren’t physicians, and they shouldn’t be making medical decisions, especially when people’s lives are at stake. Those delicate and personal decisions are best left in the hands of the patient’s doctor. Governor Sisolak’s order is bad medicine.