In common with most of my colleagues my therapeutic options are becoming increasingly influenced by the concept of “evidence base”. I don’t see this as any bad thing. It is all too easy to fool yourself about the efficacy of your treatments, and we should all be able to present independent and impartial evidence to support what we are doing.
In common with the rest of science evidence in medicine is based on the concept of the null hypothesis. There is a general view that if a certain therapy is being investigated the onus is on the proponent to provide evidence as to efficacy. It is not generally considered appropriate for others to produce evidence showing the treatment to be worthless, that is generally the default position.
This concept is what marks complementary medicine as different from conventional medicine. Whereas proper medicine is based on evidence of efficacy the proponents of woo think they should be different, and that sceptics should have to disprove their nonsense.
This view is well illustrated by a recent example. The Advertising Standards Authority have recently banned a christian group in Bath from distributing leaflets promoting faith healing. In response three MPs are insisting that the ban be reversed, writing to the ASA and demanding they provide evidence that the christian’s claims can not be justified. They clearly have no understanding of scientific method, null hypothesis, or what constitutes evidence.
That such ignorant and stupid individuals can be elected to parliament makes me despair.
The ability to freely express one’s views and opinions is very much taken for granted in Britain and the USA. Even though there may be occasional attempts to encroach on this right, those affected ultimately have recourse to the law. Article 10 of the human rights act is the ultimate safeguard in Europe, while the USA has the first amendment to the constitution.
By and large we associate this legal right with western democracies, and in our minds we associate repression of freedom of speech with autocratic and less democratic nations, particularly those with strong religious or extreme political influence.
It came as a surprise to me then to discover that Australia has no legal protection of the right to freedom of speech. No matter you might think, the principal is still respected, surely. Think again. A recent government report has recommended that the government introduce control and censorship of all media. From the big media corporations, right down to the tiniest blogger. If this law were to be passed Australia would become in effect a totalitarian regime. Australia of all places.
That this could happen in a nation we generally regard as advanced, progressive and liberal is something that should concern us all.
Re my two recent posts on doctors who will do as they're told by those in authority, rather than put the welfare of the patient as their first priority. I was advocating defiance and refusal. Well this example from the USA, which I found courtesy of another blog, is what I am talking about.
For those of you who don't understand what this is about, there are some states in America where any woman requesting a termination of pregnancy is required by law to have a transvaginal ultrasound. She then is required to view the images before the termination can proceed. This even applies when there is gross congenital malformation. Think about it.
I think my posts on various scams may have been noticed by the scammers. I am suddenly receiving a considerable number of anonymous comments which are blatant testimonials for the products. Now, if you were satisfied by the product, why would you google "(product) scam" in the first place, to bring you here. I doubt very much if these are genuine. They have been deleted.
If the scammers are reading my posts on their products I have an offer. If you provide me with some good quality evidence that your products perform as you claim, then I will present that evidence on this blog. Remember of course that anecdotes are not evidence. Especially when they are fictitious.
For the time being comments moderation has been imposed.
Not long ago I commented on the arrogant and ill informed spewings of this fucking idiot, who by virtue of his position you might expect to know better. He is the one who seriously thinks we should be “moving more towards care in the community, and patient self care,”
I commented recently on how medicine as a profession contains within it’s ranks a fair share of lowlife. One particularly vile variety of medical scum in my view is the yesman. The doctor who will obey whatever instruction comes down the line from management, even when that means tossing any concept of ethics and morality out of the window.
These types have always been around, Joseph Mengele being one of the most notorious examples. A slightly more recent example, this time from the 1950s can be found here. Just when you thought the reputation of the catholic church had bottomed out you discover new, even darker depths to which they have sunk. But in this example the church was the employer, and the medical teams involved simply went ahead and did as they were told regardless of the blatantly unethical nature of what they were doing.
Bang up to date and there are clearly doctors today who are also walking in the footsteps of Mengele. Again here blind obedience to his employers caused him to totally and wilfully disregard the welfare of his patients.
Sometimes the best interests of patients are best served by standing up and saying no. How many of us have that courage?
It might be thought that the photographer who took the picture in that last post might well have been himself the subject of police attention. We have all read stories of the police trying to stop pictures and film being taken by members of the public, quoting the “prevention of terrorism” act to justify their actions.
However if you do choose to take pictures of the boys in blue the legal position is quite clear.
If police use Section 44 of the Terrorism Act they are entitled to view any images you have taken but they are NOT allowed to delete them. They can only do so with a court order.
* Under Section 58a of the Terrorism Act, police are only allowed to stop a photographer taking pictures of officers if they reasonably suspect the photos are intended to be used in connection with terrorism.
A special date that passed me by was just a few days ago, on March 15. It was “International Day Against Police Brutality” It was a date that got very little coverage in the mainstream British media. Belatedly I have decided to highlight this day in view of something else that the media seem to have ignored.
Over the years I have seen a lot of changes, not just in the NHS but across the whole spectrum of life. But there have also been some constants. The Queen for example has been monarch for my entire life.
Another constant has been Terry Wogan. He seems to have been there in the background for as long as I can remember. Sometimes just above my eyeline, sometimes just below but always there. It’s only lately that I have started to take much notice but I have to say he is growing on me.
Take this article for example. I was just about to comment on this latest health scare here on this blog. But Mr Wogan has beaten me to it and said everything I was going to say.
Yet another image supposedly of Jesus has been reported in the DT, must be a slow day for real news. If you look at the image you can make out what appears to be a bearded man, but why does it have to be Jesus, and not just some hippie. And why would Jesus be lurking behind a stereo in Yorkshire. Looking at the image again, particularly the nose, it looks to me as if Jesus has advanced tertiary syphilis.
The guy who found it does not seem to have taken it too seriously. Unlike some of the other idiots who have found similar images in various places he has not turned the wall into a shrine. He simply painted over it with two coats of emulsion.
Until yesterday my stats package has always shown the considerable majority of visitors to this blog were from the UK. Except for those occasions when I have attracted referrer spam. For the first time yesterday another country scored more views than the UK. So what is it that makes Zorro so popular in Norway?
These scams are getting less imaginative. The latest is for a skin care product called “Revivagenics”. If you look at this one it might look familiar. It uses the exact same phrases as previous scam skincare products, and even uses before & after pictures that I have seen before advertising other products. By “before & after”, I mean before & after photoshop of course.
Scams eventually become unoriginal enough and well enough known to become ineffective. How many people out there, for example, are not aware of the “nigerian scam”. Lets hope that this desperate try to recycle an old con trick fails too.
Case reports of objects lost up the rectum are common. The variety of objects is extensive, as are the excuses as to how they got where they ended up, but this is such a story with a twist.
The patients are almost invariably male and mature adults, but apparently on this occasion the patient, who had lost a vibrator up his rectum, though male, was just 15. He was thus accompanied by his mother, who had to give consent. Perhaps unwisely the admitting surgeon asked the young lad where he had obtained a vibrator. There was a pregnant pause before the mother snapped. “It’s mine”
Viagra is one of the biggest success stories in the world of pharmaceuticals, which says something about the priorities of the general public.
An alternative to Viagra is the venom of the Brazilian wandering spider, which apparently causes priapism of about 2 hours. What this article doesn’t make clear is whether or not the site of the bite is important. Does it have to be at the required site of action, or is it a systemic effect.
Pharmacology apart I can’t think of anything less likely to induce a hard on than the prospect of a big hairy spider biting you on the knob.
Coming back to the High Court ruling on Professor Walker Smith, it is the case that the Professor’s reputation has only been partly restored. If you look at the full legal ruling there are many criticisms that the professor should have been far more vigilant in his dealings with Wakefield. He should have scrutinised what he was getting into far more closely.
I think that is a little unfair. He made in my view one fundamental mistake that we all make, only usually the consequences are not as severe. He trusted a colleague. He assumed automatically that Wakefield, as a doctor, was a man of integrity and that scrutiny and vigilance were not warranted.
I think it is fair to say that, when dealing with our colleagues trust is our default position. We assume that doctors are deserving of trust until proven otherwise, rather than the other way round. And that is why it is so easy for our unscrupulous colleagues, and there are no small number of them, to run rings round us.
This blog has featured a small number of instances where doctors, particularly in positions of management and authority have behaved in a vile, vindictive and self serving way. But this is the tip of the iceberg. I guarantee that in your hospital there are a small number of individuals you would not turn your back on.
DZ has always been of the view that the last people you want in government, are those that want to be in power. This even applies to the lib dems whose corruption as a result of their lust for power is neatly highlighted here. DZ also thinks that the coalition is on the brink of a spat that will split it and send the country into an early general election.
So who to vote for next time. Ideally you should vote for a party that manifestly has no serious ambition for power. A party that knows it will not be elected and is full of candidates who, if they thought they might win, would run a mile. These are the people we want. So when the next election comes round fuck up their day completely by putting them in power, and see the smile vanish from their faces.
The General Medical Council is the Ultimate Bully. It has the power of professional life and death over doctors, and exercises that power in an unequal, arbitrary, unfair and inconsistent manner. They are able to get away with this in the majority of cases because their decisions can only be overturned in the high court, a course most doctors find too daunting to contemplate. So excessive is their arrogance, and incompetence, that on those occasions when they are challenged in the high court they almost always lose, as in this case today.
The comments of the judge were damning. “The judge said the GMC panel failed to address whether Prof Walker-Smith had been doing research or simply investigating symptoms to help treat children. There had been "inadequate and superficial reasoning and, in a number of instances, a wrong conclusion",
True to form that slimy little shit Dickson when questioned on the matter simply changed the subject, saying "Today's ruling does not however reopen the debate about the MMR vaccine and autism.”
No-one ever suggested such a thing. The case was about whether or not Professor Walker Smith was complicit in Wakefield’s undoubted guilt. The High court said not. The GMC are said to be “considering” reforms to hearings. Don’t hold your breath, the bastards will do nothing. They will continue to behave in the same reprehensible manner, while screwing every doctor in the land for the retention fee, or as it is otherwise known, demanding money with menaces.
The GMC is beyond reform. It is not fit for purpose. It should be abolished and replaced by a properly trained, properly qualified, and properly responsible and supervised regulatory body. It is time to get rid of this bunch of incompetent, pompous and vindictive amateurs.
I have posted before on the continuing battles between the Federicci ice cream manufactures and the advertising standards authority. So far the ASA have consistently ruled against Federicci on the basis that they have upset some religious people with their irreverent piss takes of catholicism. This despite the fact that the actual number of complaints has been very small. Also despite the fact that it is perfectly legal to criticise and satirise religions. Well there is some sign that the ASA are starting to lighten up over this. Once again an ad for Federicci has attracted complaints from a tiny number of outraged arseholes who think their delusions should be sacrosanct. Only this time the complaints have been rejected. About time too.