More about Conflicts of Interest within the Medical Profession

"In 1996, shortly after we began tracking the pharmaceutical industry, we spent time looking at obesity research and the latest diet pills. In doing so, we noticed that a panel that was assembled by the government to develop a guideline for the overweight known as the Body Mass Index. And it was populated by experts, nearly all of whom had a financial tie to a drugmaker selling or developing such pills. The finding, of course, was not all that new, but the practice continues, according to a new study in BMJ, which examined panels responsible for generating clinical practice guidelines on screening and/or treatment for high cholesterol or diabetes in the US and Canada between 2000 and 2010. A good many of the panelists - and panel chairs - had conflicts of interest. But not all were disclosed."
Read article at pharmalot.com
See also Dr Briffa's recent article on conflicts of interest.

Here is an interesting blog about Ethics, Medicine, and Pharm.

Here's an interesting blog about Ethics, Medicine, and Pharm. It is written by a medical doctor, Howard Brody, M.D., Ph.D., who is an academic and an ethicist. Commendably, he is not ambiguous in his criticisms of the pharmaceutical industry and of their payments to greedy doctors who, for payment, compromise their integrity by lending their names and reputations to recommend drugs and medical devices unworthy of recommendation.

Overpaid top hospital consultants continue to ride the gravy train

The Telegraph reports that despite Britain's austerity measures and cuts in public spending, and the assurances made by the ConLib government - to overhaul the system, limiting rewards which currently give most consultants bonuses for life - massive lifetime rewards have continued to be awarded to the top consultants. The awards are meant to be for "outstanding contributions to patient care or research" and yet they are received by more than half of doctors! - How can more than half of them be outstanding? - The correct answer to that question, as you well know, is that they can't. It's got to be a fix, hasn't it? - Overpaid and on the make is a common moral failing in these materialistic days...)o: - Oops! - I forgot! - It's medical ethics, no doubt...

US apologises to Guatemala for deliberately infecting nearly 700 people with gonorrhea and syphilis

64 years ago, under the guise of leading to improved public health by discovering more about the possible effectiveness of the recently-discovered penicillin. See BBC News report. The doctors/researchers/evildoers/criminals who perpetrated this atrocity chose Guatemala because this aspect of their 'research' would not have been permitted in the United States itself, and because the people they harmed were mentally ill patients and prisoners, i.e. vulnerable groups with little power to resist or object.

This ghastly revelation "was unearthed by Prof Susan Reverby at Wellesley College. She says the Guatemalan government gave permission for the tests." - I wonder if that government regarded those victims of medical negligence as expendable? I wonder whether there was any financial or other gain for the members of that government?

I deplore the fact that although medical ethics figures a lot in medical pronouncements and studies, it does not seem to figure in the most important matter of deliberately (or negligently) harming patients. I suggest that medical students should be taught to hold certain codes of behaviour pre-eminent in their dealings with patients:

First do no harm.

If you do in fact do harm, seek immediately to remedy it or alleviate it.

Tell the truth about what happened.

Understand that harming some people in order for others to benefit from that is unethical and wrong.

Evaluate honestly the outcomes of your actions and the advice you give.

Leading scientists publicly denounce unethical use of children in GM experiments

A formal letter of protest relating to a severe breach of medical ethics has been sent by 22 senior scientists from around the world to the Tufts University School of Medicine, together with a call for these GM feeding experiments to be terminated immediately.
Read article on the website of the Alliance for Natural Health (ANH) (UK)

Human tissue could be taken from the mentally infirm without their consent and used to create embryos for experimentation, under Government proposals

Human tissue could be taken from the infirm without their consent and used for research
Article in the Sunday Telegraph

Extract:

"On Wednesday MPs will vote on a bill which would allow the creation of human/animal hybrid embryos to be used for stem cell research, change the conditions for granting IVF, and possibly liberalise the abortion laws.

The passage through Parliament of the Human Fertilisation and Embryology Bill has been dogged by controversy. Failed attempts to outlaw late abortion have dominated the debate, while scientists, medical ethics experts and religious leaders have clashed over the hybrid embryo issue.

Defenders of the bill have repeatedly stressed the importance of gaining consent from anyone whose tissue is taken for the creation of human/animal hybrid embryos.

It can now be revealed that a Government amendment, agreed after the main parliamentary debates, would allow tissue to be used from people who lack the "mental capacity" to give consent, children whose parents give permission, and anyone who has previously donated samples to hospitals for medical research but can no longer be traced.

Medical ethics experts and religious leaders are furious that the provisions, which they say ride roughshod over basic human rights, have already been agreed by an all-party committee of 17 MPs charged with scrutinising the bill, without any public debate or discussion in the main chambers of Parliament."

I believe this to be thoroughly evil.

An NHS hospital is selling placentas from new mothers for use in the development of anti-wrinkle skin creams and luxury shampoo.

NHS hospital sells placentas for cosmetic use
Telegraph article

Extracts:

"The practice made £5,000 for Poole Hospital in Dorset last year, but was today condemned by politicians and health experts.

The hospital has taken the placentas and passed them to Sigma-Aldrich, a nearby biochemical company, for five years.

Sigma-Aldrich extracts the placentas' valuable proteins, which it sells on to cosmetic scientists. Its customers include some of the world's biggest cosmetic companies."

"A spokesman said the mothers had signed a special consent form. However, the form states only that the placentas will be used for "research into...cancer, cystic fibrosis, Parkinson's disease and HIV/AIDS".

Their potential use in cosmetic research is not mentioned and mothers are not told that both the hospital and Sigma-Aldrich will profit from the trade."

Unethical and undesirable. A bit reminiscent of the Alder Hey organs scandal. - And I don't suppose anyone will get the sack for the misinformation/lies on the consent forms...)o: - You can never trust medical personnel in my opinion/experience.

Here's a rare thing: an honest doctor who admits to mistakes! - Atul Gawande

You can't get it right every time - Guardian

Extract:

""Most of the time, they are patients whom I think I've done all I possibly could for, so I can accept it. But there are always the others. Six months ago, I was performing a thyroid operation on a teacher my age and damaged a nerve that led to her vocal cords. This woman can no longer talk and has had to give up work. The only way I can live with myself is to try to do all I can for her and understand what I did wrong and do better next time. Being sorry is not enough."

Gawande is a general surgeon at the Brigham and Women's Hospital in Boston and assistant professor at Harvard Medical School. And he still makes mistakes. It's this uncomfortable wound that he has opened up, first in Complications - his bestselling book that was shortlisted for the National Book prize in the US and became the inspiration for the TV series Grey's Anatomy - and now in his follow-up, Better.

"What I'm interested in is failure," he says, "as it's the one area of medicine with which the professionals are often reluctant to engage because the stakes we are playing for are so high. We can fail by putting a decimal point in the wrong place and by not asking the right questions. If you ask any doctor when he or she last made a misdiagnosis, the truthful answer would always be in the last month. We get things wrong and we try to put them right. And, of course, we can fail with a slip of the hand. I once performed an emergency trachaeotomy in which I did everything wrong. I had the wrong knife, the wrong lights and I made the wrong incision. There was blood everywhere and the patient would have died if a colleague hadn't stepped in to help. It was horrific."

If his call for willingness to ruthlessly examine what goes wrong and why is not always shared by other doctors, then neither will be the second part of his prescription for demystifying failure. Mention league tables to most doctors and they start spitting blood, but Gawande is adamant that there is a value in open accountability. "You have to be careful you are comparing like with like," he says, by way of a caveat, "because otherwise the data can be meaningless. For instance, death rates for cardiac surgeons can vary hugely, depending on the age of their patients and the difficulty of the procedures they are undertaking. But we shouldn't allow this to disguise the fact that some surgeons and some hospitals get better results than others. And unless we are prepared to admit this, we'll never improve the overall success rates."

As an example, Gawande cites both the case of the paediatric team at a hospital in Cleveland, Ohio, who virtually single-handedly raised the average life expectancy of cystic fibrosis patients from three years old in 1957 to 33 in 2003, simply by providing aggressive preventive treatment before sufferers became visibly sick from it. You could argue that such successes are largely a matter of money, but Gawande disagrees. "We spend huge amounts of cash on healthcare in the US," he says, "and not all of it is very effective. Infection rates in hospitals are proof of this. Some hospitals have spent a small fortune on portable $5,000 hand-washing machines [superbugs are as rife in America as they are in Britain], but their infection rates have remained as high as before.

"The one hospital in the US that has managed to reduce infection to almost zero did so not by spending money but by analysing procedures. They asked doctors and nurses how they used the system and found that the alcohol gel dispensers were in the wrong place, the gowns they needed for the 3pm ward rounds were in the wrong place and that it was better to have a single stethoscope designated for each patient's sole use than for a doctor to carry his own from patient to patient.""

It's heart-warming to read, "This woman can no longer talk and has had to give up work. The only way I can live with myself is to try to do all I can for her and understand what I did wrong and do better next time. Being sorry is not enough." - Sadly Atul Gawande is rare among doctors in having this moral attitude. - Victims of medical error are mostly abandoned by the health professionals who have harmed them. That is certainly the norm in Britain. - See http://aboutsalt.blogspot.com/search/label/Andrea%20Carey and http://aboutsalt.blogspot.com/search/label/NHS%20Complaints
http://www.sin-medicalmistakes.org/
http://www.patientprotect.org/

I regard the failure of doctors to tell the truth about the causes of obesity as probably the most colossal group negligence in the history of medicine.

Obesity is not caused by overeating. It is caused by fluid retention in people who are vulnerable to salt. - See Mensa article about Obesity and the Salt Connection

Lose weight by eating less salt! Go on! - Try it! - You will feel so much better!
See my website www.wildeaboutsteroids.co.uk
(The site does not sell anything and has no banners or sponsors or adverts - just helpful information.)

Labour MP backs drug in report financed by its manufacturer

Here is another example of the workings of drug companies.

In the Sunday Telegraph of August 13, 2006, is the following report:

Labour MP backs drug in report financed by its manufacturer

which is headed

Labour MP backs drug in report financed by its manufacturer
Ben Leapman, Home Affairs Correspondent

(Filed: 13/08/2006)

Extract:

"A Labour MP has been criticised for promoting a prescription-only medicine in a pamphlet funded by the drug's manufacturer.

Medical ethics campaigners questioned the £5,000 deal involving John Mann, the MP for Bassetlaw in Nottinghamshire, and the pharmaceuticals giant Schering-Plough.

They also condemned the Fabian Society, the Labour-affiliated think-tank which published the pamphlet and secured the sponsorship."