Wednesday, June 30, 2010

Scottish doctors target supermarket booze

Treating symptoms and not the disease

As might be expected, Scottish doctors are on the rampage yet again. First, it was homeopathy, and now it’s alcohol.

In both cases, they fail to recognize the fundamental demands of ethics and humanity.

Regarding their demand that homeopathy be disregarded…no, that it be forcibly trashed by removing homeopathics from the shelves of Boots and other chemists and adding labels saying the medications are useless…please see yesterday’s column.

Regarding their demand that supermarkets not award loyalty points for purchases of alcohol, they are failing to note two significant cultural thrusts, one of which might reduce alcoholism despite loyalty points or any other commercial activity, and the other of which would place the onus for neo-Prohibitionism where it properly lies.

The first cultural factor is this: As of June 30, 2010, the picture of Sir Edward Elgar, foremost British composer of classical and religious music, is being replaced on the 20 pound note with a picture of economist Adam Smith. The government of the United Kingdom has therefore given tacit encouragement to the replacement of cultural heroes by commercial pundits. No one has yet definitively proven whether the theories of Adam Smith or Milton Friedman or Maynard Keynes or Mickey Mouse are the ones most likely to lead to the long-term economic health of nations.

On the other hand, that nations need a vibrant culture, including fine arts, music, dance and even crafts, to thrive cannot be denied. Look, for example, at the state of Afghanistan, where the arts were systematically outlawed by the outlaw Taliban. There is no beauty, no ease, no reason, really, to thrive but only to survive, and that at a basic level. Look at Soviet Russia, in which the only art allowed made giants of puny men, erecting paintings and statues of the unworthy in every public place to indoctrinate the masses. Note: It didn’t work for long.

The Scottish doctors, in their mad rush to blame alcohol itself and the means by which it is purchased for alcohol abuse are mistaking the symptom for the disease. The disease is an impoverished society, in which true cultural heroes are dismissed and mechanics who merely tinker with the conduct of life, rather than investigating the nature of life, are elevated. One cannot hear a passage written by Adam Smith and be transported beyond one’s mundane self; on the other hand, one can hear a composition by Elgar and be transported to a more refined realm, a place where commercial grasping is not seen as the stuff of life.

That is not to say that one must favour classical music to develop as a human, but that classical music is one way. Music, whether Elgar or Elton John, can lift human thoughts beyond that night’s soup, or that day’s corporate takeover. The prescriptions of economists of any age cannot. If a society replaces all cultural heroes such as Elgar with commercial mechanics such as Adam Smith, one can expect a descent into alcoholism and other forms of brutality, as the population will gradually become unfamiliar with the other gifts available to the human psyche to make life a joy and not a drudgery.

The Scottish doctors are missing another extremely cogent pointas cogent in the current climate as the dismissal of culture in favour of economic mechanics: The  movement to crack down on drunk driving has been hijacked and turned into neo-Prohibitionism, much to the dismay of the founder of Mothers Against Drunk Driving (MADD), Candy Lightner. Briefly, Lightner’s teenage daughter was killed by a drunk driver who got off with an unbearably light sentence. An enraged Lightner vowed to bring drunk driving to national attention in the US, with the goal of toughening sanctions against it and punishment for it.

However, a few years ago, Lightner was quoted regarding the organization she founded and then left this way? “It [MADD] has become far more neo-prohibitionist than I ever wanted or envisioned. I didn’t start MADD to deal with alcohol. I started MADD to deal with the issue of drunk driving.” (For more, see an article on the blog Alcohol Problems and Solutions maintained by David J. Hanson, Ph.D., at the State University of New York at Potsdam, here.)

Lightner has reportedly had three drunk driving arrests herself. If one assumes she is merely a social drinker and, like most people, caught in the finely meshed net of already-draconian drunk-driving laws, then one can see how easily she could make that statement, and how apropos it is of the Scottish doctors’ rampage.

Indeed, Scottish doctors seem to have adopted a “demon rum” attitude that goes well beyond anything even the flawed Ms. Lightner envisioned. Possibly, like any population untutored in cause and effect relationships, they have decided that since supermarkets sell a greater percentage of alcohol than do pubs and restaurants, they can make the greatest impact for their rampage by attacking supermarkets. Not, notice, the greatest impact on problems caused by public drunkenness; the greatest impact for the doctors’ reputation among the untutored masses as protectors of the public health.

A spokesman for the Wine and Spirit Trade Association pointed out that no evidence exists to suggest that loyalty points cause problem drinking, nor is there evidence to suggest that removing them would solve the problem. The spokesman was quoted by Gerry Braiden in an article in the Scotland Herald: “Surely it’s time we had a serious debate about the root causes of alcohol misuse.”

Only one doctor in the British Medical Association in Scotland spoke out against the rampage against loyalty points, and she ratified the Wine and Spirit Trade position.  Dr. Ellie O’Sullivan sensibly claimed the issue of “excessive drinking in Britain was cultural and that the motion [to disallow loyalty points] would not solve the problem.” To illustrate the ridiculous nature of the doctors’ rampage, she asked, regarding a move to ban drunkenness on public transport, “Are we going to breathalyse everyone getting on a bus?”

Unfortunately, because the doctors have claimed an expertise they lack and a vantage point they do not deserve by virtue of their appalling lack of understanding of cultural values, the answer might be yes. Twelve years ago, it would have been unthinkable to make all air travellers remove their shoes for inspection, empty their pockets, remove their jewellery, buy specially miniaturized bottles of shampoo and subject themselves to apparently random wandings and even pat-downs to go from one country to another.

And yet, it has happened.

It happens when people fail to understand cause and effect relationships and unethically transfer their efforts from finding solutions to the causative events and factors, and apply those efforts instead to altering the effects, regardless of how ineffective such an action might be. One can bring down a high fever by tossing a patient into a bathtubful of cold water, but the patient might die unless the cause of the disease is located and treated. Indeed, the patient might die more quickly because fever is one way the body fights an infection; without the heat, conceivably the disease organisms would be much happier and grow much faster.

Likewise, removing a scintilla of alcohol from shopping carts would seem to be no more than an ice-water bath, and one applied not only to those suffering a disease, but to the disease-free as well. That, alone, makes their “cure” for alcohol abuse unethical. But it is more unethical than that; it simply adds a bit more financial suffering to those who are already suffering alcoholism and does absolutely nothing to address the underlying cause. Nothing at all.

In a purely practical sense, one wonders how long the doctors would retain any patients if they gave all of us expensive prescriptions for streptomycin when only one-half of one percent of us actually had a strep throat?

Tuesday, June 29, 2010

The National Health Service, Homeopathy and Public Ethics

 Hippocrates by Rubens

Hippocratic? Or Hypocrites?

This week, there are two thrusts in coverage of planned National Health Service cutbacks in the United Kingdom. The first involves which programs to cut; up for consideration is extensive payment for fertility treatments. Also up is coverage of homeopathy, a 200-year-old system of medicine subscribed to by the Royal Family, lots of other Brits, a few Americans, tons of Indians (many of whom live, in fact, in England) and many, many French people.

Homeopathy is regarded by mainstream doctors as nothing more than placebos. They believe this because, as mechanics more than scientists, philosophers or artists―all of which physicians were meant to be in more enlightened times as recently as the 18th century―they cannot find any trace of active ingredients within the pellets and liquids dispensed by homeopaths. Modern doctors are apparently ignorant of quantum physics and the work of Dr. Masuro Emoto in which he found that the molecular structure of water changed depending on whether it was from a clear mountain stream or a polluted urban river. Not the contents of the water, mind…the water itself. That is how homeopathy works; the active ingredient, often a poison if used at full strength, is diluted in an inert substance such as purified water and during the process, the active ingredient’s properties are transmitted to the inert carrier.

So, upon that brief and somewhat inexact explanation of how homeopathy works (and it would be inexcusable for me to fail to admit that it is the only form of medicine I have used for more than 30 years), the questions are these:

One form of medicine fits all?
1.  Is it ethical for a doctor to proceed against a form of medical treatment different than that to which he adheres despite a portion of the public believing it is in their best interest to follow that alternate form of medicine?

2.  Is it ethical for citizens and their elected politicians to deny public coverage for such treatments on the same basis as coverage for mainstream treatment?

Regarding question one: If a doctor actually follows the Hippocratic Oath, which admonishes “first, do no harm,” then clearly by removing equal coverage out of public coffers for a minority medical system, they are doing harm. Often, they say they are “protecting” that public from wasting money (their own and the public’s) on what they say are ineffective treatments.

First, those treatments are not ineffective if they promote health in those who use them, which they do, regardless of what the doctors see or do not see in the chemical components of those substances, or on how many double-blind studies have or have not been conducted. (Aside from which, not a week passes that there is not another revelation regarding bogus studies for deadly mainstream pharmaceuticals…so much for “real” science.”) So, on a purely factual basis, they are acting unethically.

When did doctors become God?
Second, on what day did the public relinquish its prerogative to choose its own health care to doctors, or any other so-called and/or self-proclaimed expert? In short, on what day did God (if you believe in one) decide to share power with those who are members of a large, national medical association in some developed nation or other?

Printed below is a copy of a version of the Hippocratic Oath used in many medical schools today. It was written by Louis Lasagna in 1964; he was academic dean of the School of Medicine at Tufts University.

Dr. Lehany, Scotland’s answer to the Luddites
The portions of the Hippocratic Oath which particularly address the issues raised here are italicised. I would particularly draw those to the attention of Dr. Gordon Lehany, author of the most recent assault on homeopathy from the UK medical establishment. Dr. Gordon Lehany is chair of the British Medical Association’s Scottish junior doctors committee, and therefore inordinately influential for the future of medical practice in the UK.

Money, greed and ignorance
Regarding question two―Is it ethical for citizens to justify denial of alternative medical coverage on financial grounds?―the answer is simple. No.

Many of those commenting on public forums on this issue cite the same sorts of mechanistic pseudo-evidence as Dr. Lehany might cite. But by ignoring the work of Dr. Emoto and Canadian researcher Dr. R.H. Clark, who altered the character of water by what he placed next to it, it is as if they are trying to convince themselves and the rest of us that the Remington Standard typewriter is preferable to the computer for quickly producing typed sentences…because the Remington is the one they know how to operate and fix, while they are mystified by computing.

But many raise the issue of cost, as well. Why, they ask, should they pay for this “magic” medicine with their tax dollars?

Again, the answer is simple: Because in a democratic society, each member is responsible for not only his or her own happiness and right to pursue same, but those same rights for every other member. Most people who use homeopathy don’t think much of Big Pharma and its killer compounds, and yet, one doesn’t read of them refusing to spend much larger amounts on it because it is what the majority favour. They actually believe the Hippocratic dictum, First, do no harm. And it would be harmful to a population of sick people to badger and threaten them about the means they have chosen through which to heal, even if one doesn’t personally favour it.

One reaps what one sows. Dr. Lehany is sowing hostility and pandering to a narrow world-view, if not practicing thinly veiled greed. The public commentators are expressing both ignorance and hostility and the obverse of greed, parsimony.

Worse, parsimony directed at those they do not know and yet would harm.


I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death.

If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.