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AG Alan Wilson: Ivermectin, hydroxychloroquine for COVID should be up to doctor, patient

The opinion makes no determination on the effectiveness of ivermectin or hydroxychloroquine but says doctors have right to try them with patient consent.

COLUMBIA, S.C. — South Carolina's attorney general said in an opinion on Friday that doctors should have the right to prescribe "off-label" medications to treat COVID - even if that includes two drugs that have stirred up controversy.

Alan Wilson issued the opinion at the request of State Senator Shane Martin and State Representative Bill Taylor who specifically asked about whether doctors should be allowed to prescribe ivermectin and hydroxychloroquine. The medications have made national headlines for their use in treating COVID despite limited or no scientific proof, so far, that they are effective.

But Wilson said it's not for his office to decide whether they are the best course of action for a patient, citing state law that heavily protects the relationship between a patient and a doctor.

“Nevertheless, we can point out, and fully support, the general law protecting the physician's decision, particularly if informed consent is obtained,” Wilson said.

The opinion also looked at the liability of doctors, pharmacists, and hospitals in this process. Citing past cases from around the country and existing South Carolina law, Wilson's opinion showed that doctors acting in the interest of a consenting patient using their medical knowledge faced limited liability.

Doctors are also further protected through a joint resolution by the South Carolina General Assembly in 2021 that provides limited immunity to doctors who prescribe off-label drugs specifically for COVID-19.

Similarly, pharmacists filling prescriptions written by doctors would likely see no liability since, in an earlier opinion by the attorney general's office decades earlier, "a pharmacist cannot interfere in the doctor's decision."

This was the finding of an opinion written by former Assistant Attorney General Karen L. Henderson in 1976.

Meanwhile, in Friday's opinion, Wilson said that hospitals also have a duty to the patient to "obey the instructions of a doctor, absent the instructions being obviously negligent or dangerous." 

As such, he said that the hospital's right to take action against a prescribing doctor largely depends on the individual situation and all facts involved. That, he said, means the attorney general's office couldn't provide a sweeping answer in terms of hospital liability. However, the opinion also cited Supreme Court opinion suggesting that a hospital "may not interfere in the medication prescribed by a physician."

In conclusion, Wilson took the side of a Nebraska attorney general that the mere prescription of controversial "off-label" medication does not justify filing a disciplinary action against a physician.

He added that while the questions surrounding the medicines still linger, there are no easy answers dealing with COVID. 

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