I've had a general background mistrust of the 'six litres of water/vitamin supplements/organic food/five a day" 'science' for a while. Too much seemed to be taken too literally with too few footnotes to seem wholly true.
I therefore found this article "Science and Pseudoscience in Adult Nutrition Research and Practice" by "CSI" (Committee for Sceptical Inquiry) quite interesting.
Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts
09 September, 2009
07 September, 2009
Healthcare Myths and Facts
I was on McSweeney's and I quite enjoyed this piece of analysis within commentary on the American healthcare debate... Can't help but feel he might just have hit the nail on the head there!
MYTH:
People in Britain are deeply unhappy with their socialized medicine system, which ours will become.
FACT:
People in Britain are deeply unhappy with everything. It is their only source of happiness.
20 February, 2009
placebo+nudge=panacea?
Interesting article on Comment Central about placebos, both in medicine and in the economy.
I don't think homeopathy works, per se. However, it certainly has an effect when people think it will. Given that many diseases to have a psychological link (look at how quickly many patients recover when told they will be discharged in the next few days) then perhaps it is as well to continue to use homeopathy for 'homely' diseases - ie: fairly regular, uncomfortable but non-life threatening - such as eczema. Just because the science doesn't add up, if the sugar pill has the same affect on the patient as the 'real' pill and sugar is cheaper, give out lots of sugar pills.
The time I think there is a problem is obviously for diseases such as cancer. If people have got used to believing the sugar pill works for their coughs and colds, I can easily see a number of people trying the same for their cancer.
In the economy, I agree with the article's 'unethical' point, but equally, all of the economy is a confidence game (I don't say this is bad) so perhaps there could be a middle line to tred betweenthe outright lie and the modifying of behaviour - perrhaps a 'nudge' is what is needed.
I don't think homeopathy works, per se. However, it certainly has an effect when people think it will. Given that many diseases to have a psychological link (look at how quickly many patients recover when told they will be discharged in the next few days) then perhaps it is as well to continue to use homeopathy for 'homely' diseases - ie: fairly regular, uncomfortable but non-life threatening - such as eczema. Just because the science doesn't add up, if the sugar pill has the same affect on the patient as the 'real' pill and sugar is cheaper, give out lots of sugar pills.
The time I think there is a problem is obviously for diseases such as cancer. If people have got used to believing the sugar pill works for their coughs and colds, I can easily see a number of people trying the same for their cancer.
In the economy, I agree with the article's 'unethical' point, but equally, all of the economy is a confidence game (I don't say this is bad) so perhaps there could be a middle line to tred betweenthe outright lie and the modifying of behaviour - perrhaps a 'nudge' is what is needed.
24 June, 2008
The Pill - now online!
A website has just been set up allowing women to order to pill over the internet rather than having to go to their GP.
Ok, so at the moment, I wouldn't use this because they charge for the pill, unlike the NHS where it is free.
However, I support the idea 100%. I find the currant situation ludicrous. You can be on the pill for over 5 years with no negative side effects at all, but every time you need a new prescription you have to make an appointment and then get yourself to your GP. Repeat prescriptions aren't available. GPs only usually work 9-5, Monday to Friday which is fine if you don't work, but unfortunately this isn't the 1950s and most women do now work.
Its a bit like family planning clinics only being open 10-1, Mon, Wed and Fri. Not so good if it's emergency contraception that you need!
The pill should continue to be free from the NHS, but as all they do at the GP is weigh you, test your blood pressure and ask if nyone in your family has died of a heart attack, frankly, the pharmacist in Tescos is equally qualified to do that and Tescos is far more convenient for 90% of the population.
I don't understand the opposition that the GMC (etc) are making to this. This article all sums it up quite well.
Ok, so at the moment, I wouldn't use this because they charge for the pill, unlike the NHS where it is free.
However, I support the idea 100%. I find the currant situation ludicrous. You can be on the pill for over 5 years with no negative side effects at all, but every time you need a new prescription you have to make an appointment and then get yourself to your GP. Repeat prescriptions aren't available. GPs only usually work 9-5, Monday to Friday which is fine if you don't work, but unfortunately this isn't the 1950s and most women do now work.
Its a bit like family planning clinics only being open 10-1, Mon, Wed and Fri. Not so good if it's emergency contraception that you need!
The pill should continue to be free from the NHS, but as all they do at the GP is weigh you, test your blood pressure and ask if nyone in your family has died of a heart attack, frankly, the pharmacist in Tescos is equally qualified to do that and Tescos is far more convenient for 90% of the population.
I don't understand the opposition that the GMC (etc) are making to this. This article all sums it up quite well.
16 May, 2008
What makes us human?
Violent Acres has a really interesting post on her views on what makes us human as opposed to just animals.In her view, it's our ability to experience empathy and worry about the wider picture rather than just worry about ourselves and where our next meal is coming from. More here.
14 May, 2008
09 May, 2008
European Abortion Limits
Just seen this on the comments from this article, in the context of my post on abortion, it seems interesting.
To put the discussion in some sort of context, here are the legal limits for abortion in European countries ...
Illegal -- Ireland, Malta
10 weeks - Poland, Slovenia
12 weeks -- Austria, Belgium, Bulgaria, Czech Republic, Denmark, Estonia, France, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Luxembourg, Slovakia, Switzerland
13 weeks -- Netherlands
14 weeks -- Romania
16 weeks -- Portugal
18 weeks -- Sweden, Norway
20 weeks --
22 weeks -- Spain
24 weeks -- United Kingdom now
28 weeks - United Kingdom (1967-1990)
07 May, 2008
Abortion
A fairly simplistic article on the subject here made me think about my views on the subject again.
It's difficult, I think abortion is horrid, wicked and wrong. It should be quite right to try and reduce the number of abortions and abortion should not be applauded.
Yet I'm pretty sure that if I was to find myself pregnant tomorrow, I'd have one. Even if my life is stable enough today that I'd continue with the pregnancy, I know that if I'd have found myself pregnant a couple of years ago, I certainly would have had one.
Of course, I'm in the slightly nicer moral zone of having taken the type of precautions in advance that I hope mean I will never have to make the choice.
If a woman has become pregnant whilst using contraception, or after she though she could no longer bear a child or - obviously - in the especially nasty situations of rape etc, then I have no condemnation for that women. The pregnancy is not her fault, either because it was not foreseeable that it should happen because she was taking steps to prevent it or because not being able to take the relevant steps was forced on her by another.
However, regardless of the circumstances in which a woman became pregnant, I feel that a line must be drawn somewhere. The question therefore becomes, where should that line be drawn? In the UK at the moment, it's 24 weeks. In other European countries, it is much lower - I believe the limit in the Netherlands is 16 weeks.
Whatever the teachings of the relevant authorities say on the subject, I simple cannot believe that a fertilised egg is 'alive'. If the potential for life is the criteria, then with modern technology, we could make a human from the DNA in my hair. We can grow back fingers that have been chopped off (it looks like magic!). The potential for life is everywhere.
Equally, I cannot accept that a 39 week old foetus is not alive. If it were born, even without intervention, it could survive. It feels pain, it moves, it responds to external stimulus, it just feels human as a gut instinct.
Many people point out the irony of there being two wards in a hospital. In ward A, the doctors are aborting a 22 week old foetus. In the other, they are saving a pre-maturely born 22 week old child.
The idea of basing abortion time limits on the viability of a child (with medical assistance) is superficially attractive and feels fair. However, whilst it seems to be an appropriate moral ground upon which to base the decision at the moment, in the long run I think it is dangerous. 16-24 weeks shows a balance of interests between the mother and the foetus. But, medical technology is always improving and maybe, in the future, there will be viability at 6 weeks, or earlier.
Then there is no balance.
I think we need to find a different moral basis on which to base the decision.
More posts when I think of what it might be.
It's difficult, I think abortion is horrid, wicked and wrong. It should be quite right to try and reduce the number of abortions and abortion should not be applauded.
Yet I'm pretty sure that if I was to find myself pregnant tomorrow, I'd have one. Even if my life is stable enough today that I'd continue with the pregnancy, I know that if I'd have found myself pregnant a couple of years ago, I certainly would have had one.
Of course, I'm in the slightly nicer moral zone of having taken the type of precautions in advance that I hope mean I will never have to make the choice.
If a woman has become pregnant whilst using contraception, or after she though she could no longer bear a child or - obviously - in the especially nasty situations of rape etc, then I have no condemnation for that women. The pregnancy is not her fault, either because it was not foreseeable that it should happen because she was taking steps to prevent it or because not being able to take the relevant steps was forced on her by another.
However, regardless of the circumstances in which a woman became pregnant, I feel that a line must be drawn somewhere. The question therefore becomes, where should that line be drawn? In the UK at the moment, it's 24 weeks. In other European countries, it is much lower - I believe the limit in the Netherlands is 16 weeks.
Whatever the teachings of the relevant authorities say on the subject, I simple cannot believe that a fertilised egg is 'alive'. If the potential for life is the criteria, then with modern technology, we could make a human from the DNA in my hair. We can grow back fingers that have been chopped off (it looks like magic!). The potential for life is everywhere.
Equally, I cannot accept that a 39 week old foetus is not alive. If it were born, even without intervention, it could survive. It feels pain, it moves, it responds to external stimulus, it just feels human as a gut instinct.
Many people point out the irony of there being two wards in a hospital. In ward A, the doctors are aborting a 22 week old foetus. In the other, they are saving a pre-maturely born 22 week old child.
The idea of basing abortion time limits on the viability of a child (with medical assistance) is superficially attractive and feels fair. However, whilst it seems to be an appropriate moral ground upon which to base the decision at the moment, in the long run I think it is dangerous. 16-24 weeks shows a balance of interests between the mother and the foetus. But, medical technology is always improving and maybe, in the future, there will be viability at 6 weeks, or earlier.
Then there is no balance.
I think we need to find a different moral basis on which to base the decision.
More posts when I think of what it might be.
24 April, 2008
May 15th
In line with the popular 'because we can' flash mob attitude, for those of you who haven't seen, there is a plan afoot whereby on May15th 2008, about 220,000 people will panic buy carrots. In the UK, this looks to be between 50,000-100,000 people.
I urge everyone to join in this enterprise to pay homage to the absurd and surreal.
I urge everyone to join in this enterprise to pay homage to the absurd and surreal.
15 April, 2008
Fathers, Mothers, Hospitals and the State
I was shocked today that fathers are being pushed out of maternity wards even when the mother wants them to be there!
If the couple have decided that they don't want the father there, of course he should not be compelled.
If the mother has decided that she doesn't want the father there, I believe her wishes trump the fathers as it is her going through the process.
But where both parties are in agreement that they both want both people to be there, what kind of backward Saudi-esque thinking are the maternity nurses employing bundling the fathers out?
I feel that not only do medical guidelines on the parents of babies need to be re-considered, but other guidelines do too.
Under the status quo, a woman who becomes pregnant (subject to certain conditions) is entitled to 1 year of maternity leave. Fathers of new babies are entitled to 4 weeks. I accept that in the majority of families, traditional gender roles are still happening. I wouldn't force people to change this against their will. But the current set up is an active barrier to change should the parents want a different family set up.
My solution would be to distinguish between the biological aspects of pregnancy and childbirth and the social aspects. If the mother chooses, she should be able to have roughly 6 weeks of parental leave (some to be taken before the due date, 4 weeks or so to be taken after the due date). That accounts for the biological aspects where the burden is shared solely by the woman, however supportive her partner is. The year which women currently get off as maternity leave should be re-labelled parental leave and it should be up to the parents of the new born to deicde how they wished to split this leave.
Now, what happens if the father of the child is irresponsible, refuses to take care of the child but demands his right to parental leave (ie. getting something for nothing). Well, maybe it seems unfair (but still better than the SQ) but I would say the decision for allocating the maternity leave should be legally left to the woman. In the vast majority of cases, this can then be decided jointly, but use the woman's signature to confirm the decision made. In cases where there is conflict between the woman and the man, realistically in these situations - where there is a newborn- conflict will end up with the woman taking care of the baby. It seems sensible that she should then get the childcare.
I also think that as babies are generally considered to be a social good, the burden of paying parental leave should be shifted from the employer to the government.
One added bonus of this scheme? At the moment, women are being seen as a liability by potential employers as they may get hired and then promptly take a year off to care for children. By giving both parents equal rights, both are equally risky to employers to there is no point in favouring one sex over the other.
If the couple have decided that they don't want the father there, of course he should not be compelled.
If the mother has decided that she doesn't want the father there, I believe her wishes trump the fathers as it is her going through the process.
But where both parties are in agreement that they both want both people to be there, what kind of backward Saudi-esque thinking are the maternity nurses employing bundling the fathers out?
I feel that not only do medical guidelines on the parents of babies need to be re-considered, but other guidelines do too.
Under the status quo, a woman who becomes pregnant (subject to certain conditions) is entitled to 1 year of maternity leave. Fathers of new babies are entitled to 4 weeks. I accept that in the majority of families, traditional gender roles are still happening. I wouldn't force people to change this against their will. But the current set up is an active barrier to change should the parents want a different family set up.
My solution would be to distinguish between the biological aspects of pregnancy and childbirth and the social aspects. If the mother chooses, she should be able to have roughly 6 weeks of parental leave (some to be taken before the due date, 4 weeks or so to be taken after the due date). That accounts for the biological aspects where the burden is shared solely by the woman, however supportive her partner is. The year which women currently get off as maternity leave should be re-labelled parental leave and it should be up to the parents of the new born to deicde how they wished to split this leave.
Now, what happens if the father of the child is irresponsible, refuses to take care of the child but demands his right to parental leave (ie. getting something for nothing). Well, maybe it seems unfair (but still better than the SQ) but I would say the decision for allocating the maternity leave should be legally left to the woman. In the vast majority of cases, this can then be decided jointly, but use the woman's signature to confirm the decision made. In cases where there is conflict between the woman and the man, realistically in these situations - where there is a newborn- conflict will end up with the woman taking care of the baby. It seems sensible that she should then get the childcare.
I also think that as babies are generally considered to be a social good, the burden of paying parental leave should be shifted from the employer to the government.
One added bonus of this scheme? At the moment, women are being seen as a liability by potential employers as they may get hired and then promptly take a year off to care for children. By giving both parents equal rights, both are equally risky to employers to there is no point in favouring one sex over the other.
14 April, 2008
Organ donation
There has recently been the story of a woman who died who had, whilst living, signed up to donate her organs. He mother had problems with her kidneys and was awaiting a transplant. The daughter, everyone agrees, was quite clear that she wanted her mother to have her kidneys and was in the process of signing up to be a living donor. The daughter died before she could put this desire in writing. When she died, her organs were taken and given to strangers on the usual allocation basis of the organ donor registry. The mother therefore didn't get the kidneys.
This is an interesting ethical dilemma. On the one hand, there is broad agreement that medicine should try and save as many lives as possible, that's why we have a system of triage. On the other hand, we recognise the rights of living people to donate to whom they please, why does that right cease on death? Seeing as we do recognise that the dead have rights (that's why we have wills, don't allow medical experiments on dead people without consent and why digging up dead bodies is heavily regulated), why should the right to decide where ones organs go stop when you are dead where a clearly, undisputed request to the contrary has been made?
If people were never allowed to have a say in where their organs went after death, I suspect the number of organs donated would go down. Had the two men who received the daughter's organs in this case not received them, they may have died waiting.
All in all, what probably sways me in this particular case are a number of secondary considerations. The daughter, in this case, had a daughter of her own (Macie). The mother was the main carer of Macie. Now the daughter has died, she is the sole carer. I'm not a doctor, but various research programmes (ahem, House, Scrubs...) have taught me that organs can be rejected. The closer to donor and donee are genetically, the less likely rejection is. A daughter donating to her mother, therefore, suffers far less chance of rejection than the two men who received the organs. As the mother is also now the carer of Macie, the pendulum swings even further in her direction. To lose a mother is bad enough, to lose your guardian a while later, even worse.
The decision is difficult as it has to balance human lives, but in this case, I would have given the kidneys to the mother, not the strangers.
This is an interesting ethical dilemma. On the one hand, there is broad agreement that medicine should try and save as many lives as possible, that's why we have a system of triage. On the other hand, we recognise the rights of living people to donate to whom they please, why does that right cease on death? Seeing as we do recognise that the dead have rights (that's why we have wills, don't allow medical experiments on dead people without consent and why digging up dead bodies is heavily regulated), why should the right to decide where ones organs go stop when you are dead where a clearly, undisputed request to the contrary has been made?
If people were never allowed to have a say in where their organs went after death, I suspect the number of organs donated would go down. Had the two men who received the daughter's organs in this case not received them, they may have died waiting.
All in all, what probably sways me in this particular case are a number of secondary considerations. The daughter, in this case, had a daughter of her own (Macie). The mother was the main carer of Macie. Now the daughter has died, she is the sole carer. I'm not a doctor, but various research programmes (ahem, House, Scrubs...) have taught me that organs can be rejected. The closer to donor and donee are genetically, the less likely rejection is. A daughter donating to her mother, therefore, suffers far less chance of rejection than the two men who received the organs. As the mother is also now the carer of Macie, the pendulum swings even further in her direction. To lose a mother is bad enough, to lose your guardian a while later, even worse.
The decision is difficult as it has to balance human lives, but in this case, I would have given the kidneys to the mother, not the strangers.
12 March, 2008
Deaf parents chosing deaf babies
The background to this is that some deaf parents have demanded the right, when using treatments such as IVF to select for deafness in their child. Their arguments tend to focus around the idea that the deaf community, of which they are part, cannot be wholly welcoming to a hearing person so, as a result of being able to hear, the child will be excluded from their parents' community and that this is bad.
Hmmmm, well, instinctively, being able to select for deafness seems wrong. Whilst a deaf child is no doubt morally, legally and ethically equal with a hearing child, the fact remains that they will be acting under some level of disability in their interactions for the rest of their life.
If their deafness is not so severe that a hearing aid can help then, then what is the point of selecting for deafness in the first place when technology has helped them hear? If they are so profoundly deaf that a hearing aid cannot help them then they will miss out on a large part of the human experience because their interaction with other people is automatically limited. If a parent in a wheelchair wished their child to be born unable to walk because it would help them engage better with the wheel-chaired community, we would consider it a travesty. How is deafness different?
The one exception would be that many deaf people are able to lip read. Reading the background of the deaf groups mentioned in the article, many of these groups oppose lip reading on the grounds that in some way it's 'selling out' from being deaf. Hmmmmm.
If two deaf parents have a hearing child, the child will no doubt learn sign-language from his parents and therefore be able to engage in the deaf community. The child will also be able to fully engage in the non-deaf community. This child would seen to be in a good position in being able to be part of both communities as he wishes. What right do the parent's have to deliberately and artificially restrict this choice?
Hmmmm, well, instinctively, being able to select for deafness seems wrong. Whilst a deaf child is no doubt morally, legally and ethically equal with a hearing child, the fact remains that they will be acting under some level of disability in their interactions for the rest of their life.
If their deafness is not so severe that a hearing aid can help then, then what is the point of selecting for deafness in the first place when technology has helped them hear? If they are so profoundly deaf that a hearing aid cannot help them then they will miss out on a large part of the human experience because their interaction with other people is automatically limited. If a parent in a wheelchair wished their child to be born unable to walk because it would help them engage better with the wheel-chaired community, we would consider it a travesty. How is deafness different?
The one exception would be that many deaf people are able to lip read. Reading the background of the deaf groups mentioned in the article, many of these groups oppose lip reading on the grounds that in some way it's 'selling out' from being deaf. Hmmmmm.
If two deaf parents have a hearing child, the child will no doubt learn sign-language from his parents and therefore be able to engage in the deaf community. The child will also be able to fully engage in the non-deaf community. This child would seen to be in a good position in being able to be part of both communities as he wishes. What right do the parent's have to deliberately and artificially restrict this choice?
17 December, 2007
Anorexia: Not caused by thin models
Scientists investigating anorexia and other similar eating disorders have said that they may not be caused or triggered by pictures of thin models or an aspiration to look that way, but rather by an inherited tendency in the brain to respond to pleasure and reward in a particular way.
Here.
Here.
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