Lyme Disease: A Bioethical Morass

Abstract

Primum non nocere", "first do no harm" is a medical dictum based in antiquity. Yet, in nearly everything related to Lyme disease, it seems almost entirely disregarded. How ethical is it that we follow the guidelines of the CDC regarding diagnosis when those guidelines require erythema migrans that is clearly recognizable only in one ("bullseye rash") of its multiple presentations? Further, how ethical is it that we are held to guidelines regarding a positive serology that is positive (at best) only 40% of the time? Another questionable ethical situation is the use of a bacteriostatic antibiotic that barely meets the MIC for Borrelia burgdorferi in its ordinarily prescribed regimen. It is also dependent on compliance which is a huge issue because of the gastrointestinal side effects. This antibiotic may clear the rash, but seemingly does little to prevent late findings of the disease. The sub lethal antibiotic dose can be important in the subsequent development of biofilms that lead to a chronic disease state. Lastly, how ethical is it that we have nearly abandoned our patient advocacy and permitted the insurance companies to dictate allowable treatment? And, in as much as Borrelia organisms were found in the brains of Alzheimer's disease patients over 25 yrs ago and those spirochetes have recently been shown to produce biofilms, how ethical is it that we ignore research underpinning the pathogenesis of this disease? The intent of this work is to discuss how all aspects of Lyme disease (LD) are bioethically challenged. We include Alzheimer's disease (AD) in the discussion because Lyme spirochetes have been found in, and cultured from, the brains of AD. This makes LD, in its presentation as AD, the equivalent of tertiary neurosyphilis with the only difference being a different spirochete.

Bioethics and Psoriasis

“…We have recently completed an ethical analysis of Lyme disease and have found the ethics to be challenged in all aspects of that disease from diagnosis through laboratory evaluation to treatment and outcomes [1]. Psoriasis differs from Lyme disease in that many fewer targets for ethical discussion are present.…”

The Financial Implications of a Well-Hidden and Ignored Chronic Lyme Disease Pandemic

“…The CDC still uses the IDSA terminology ‘post-treatment Lyme disease syndrome’ (PTLDS) [ 63 ]. It is unlikely that the IDSA’s lack of medical ethics when it comes to Lyme disease [ 64 ] was the reason why the CDC stopped officially endorsing IDSA treatment guidelines for Lyme disease, because in 2016 an anonymous whistleblower group of scientists from within the CDC, calling themselves CDC Scientists Preserving Integrity, Diligence and Ethics in Research (CDC SPIDER), raised concerns about the CDC’s lack of independence and ethics [ 65 ], stating, “We are a group of scientists at CDC that are very concerned about the current state of ethics at our agency. It appears that our mission is being influenced and shaped by outside parties and rogue interests”.…”