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Archive for the ‘bio ethics’ Category

Modern  men think they are invincible .  They can innovate every thing under the sun with their sixth sense . Alas  . . . we forget  human values  ! .It does not require a least of   that  special sense   . Reaching out to a life in distress   require  an animal sense !

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The Antics ! Crossing a bridge with fifth sense ! The Hindu  5th April 2013 Image : Michale Nongthombam.

A bunch of  Ants plan   how to  ferry   a daughter Ant  , across a broken bridge and execute it  efficiently with their tiny little cerebrum !  

While , we boast around  with the  later   . . . still   . . .   there is no end in sight for all those  self   inflicted sufferings . . .   these lesser mortals  live happily  in this human infested planet !

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If you are a doctor  and  whatever  be your specialty   . . .  if you do  not read this article  and understand the nuances  probably you  will not become a   complete medical professional !

Master health check up futility general health check

master health check up geenral health checks bmj british medical journal cohcrane nordic

 

While  BMJ  struggles to  propagate  a vital truth , this  banner on a  Indian  high way   tempted the public  to go for 64 slice CT scan   . . .just like that !

Master health check up 2

Final message

Accruing medical knowledge and skills is only one aspect of medical profession. Applying it properly in our patient population is entirely  different ball game . Let us be disease curers and not disease hunters . This is important because disease  hunting is  a dangerous  game ,  where victims can be innocent  bystanders. This  is exactly same thing  Hippocrates  refered to as  Primum non nocere  1000 years ago.  It  has required  a huge statistical study to RE-INVENT  this universal fact !

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I was stunned to read this article regarding the proliferation of open access , author paid scientific literature   from “The Hindu ” dated 27th  September 2012 .

It only shows how the scientific world is being consumed by  commercial interests .

It seems at every level of journal creating and publishing  there is vested interest .

I wonder   peer reviewed journals  could mean nothing in the near feature .

Let us   join the new movement  called  “Paid science”

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Medical science and commerce grow hand in hand .  Many believe   the field  of   medicine has  ceased to be a pure  science long ago . Both are mutually inclusive . We have no other option ! If there is no commercial interest   . . .Who will fund cardiology research ?  Then  . . . How are you going to  develop a biological pacemaker or  the  eagerly  awaited  total artificial heart ?

Without involvement of the commercial forces ,  no break through is possible . If you take medical science  , majority of growth has occurred by the motivational force of  medical industry  . Here is an  exclusive website for sub specialty called cardiopulmonary business .

But do we  have  the  medical research in safe hands ?

Why  a  hastily  developed  cardiac  device enter  the human domain and recalled within 2 years  fearing grave Injury   ?

Why a drug known to cause serious side effect was purposefully  blinded with a hidden agenda  till the drug earns a  billion or two ?

What is in store for future generations  ?

When the profession is at the mercy of  forces other than  patient care as a primary aim  there is every reason for it  go awry and  become   a dangerous health hazard  . If any medical professional   who does not see this , as an important issue  for man kind ,  requires a rebooting for reality  !

Public should realise , what they often get  in the name of science  is  a huge  human body trial and victims of   biological  shopping  . It has   wide-ranging  Implication . It is ironical , we are in a piquant  situation , where   our bio-system   has to  fight not only against  the  diseases but also  the misplaced scientific methodology  and fraudulent practices.

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A  72 year old man in  terminal heart failure with  three previous admissions in  last one year  comes with severe breathlessness . He was  exhausted with  rigorous  drug regimens  for refractory heart failure in the past few months. Since he  was always feeling better after an infusion of Dobutamine he demanded it . Doctors were very clear  , ” Repeated  Dobutamine infusion will  hasten  the LV dysfunction and longevity is  will shorten”

The family began to think . While they  wished  for him to   live longer , the sick man  insisted  on  early  relief from his  symptoms .

How often in medicine ,   there is a trade off  between  symptoms and survival ?

It is a more common situation than we believe , especially in many  chronic  disorders like terminal organ failure and malignancies. .  So we need a simple scale to  asses the quality of life and survival  outcome for our patient. The following table  could help us . I  learnt this from   the great teacher Valentine Fuster’s  lecture  which  I attended in New Delhi recently !

Final message

Let us  attempt to  make a patient’s  life ” feel  good “ ,  if  he is going to live shorter .  Let us avoid  prolonging  a  life ,  if the treatment is making him feel  bad  , when the  life  expected  is  short !

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An  article , I stumbled upon recently  discusses why American health care is  in deep trouble. There is a huge variation in the health care costs across the country. The article goes on to reveal  ,   a  simple  Appendicectomy can  cost  anywhere between 7500   to 1,70000 $  in different hospitals in USA.  (In India it costs  1000 $  in  any  star hospital !)

The fundamental flaw is   treatment  being the same ,   it is delivered in such a  fashion ,  the cost incurred is  kept ridiculously high.

It is akin to comparing  a 10 dollar  lunch to a 1000 dollar feast , both  ultimately  fulfills a  purpose ,   relive the hunger effectively

while , the later can  damage the country’s economy  in a variety of ways !

https://www.massdevice.com/blogs/massdevice/anatomy-walletectomy

Car makers automate the industry with Robots to   reduce  the  human labor and  cost of a vehicle ,  while medical industry does the opposite   . . .  privileged few get their appendix removed with a help of metal hand  !

Final message

Modern medicine must  aim to improve the quality  of  care  with a   positive impact  at a reasonable cost . In the name of cutting edge technologies ,  it  should not raise  the medical bill in a meaningless  fashion .This is meager exploitation of  human suffering.

It is  hilarious to note  certain medical  Robots* are primarily  made to assist  surgeon  for which  no assistance is required at all !  (I heard a story about a  Robot  which responds  to voice command   and pass on a   knife  for cutting and a gauze for wiping ! What a great medical discovery !)

Disclaimer

*  Of course  Robots (Cyber knifes )   may have a role  in some rare surgeries which require high precision  cutting  especially in  Neuro  ,  Vascular ,  oncological  surgeries.

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