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South Dakota’s Abortion Script: The Hijacking of Informed Consent

In a previous post, I suggested that informed consent could sometimes be misused. South Dakota has provided a clear example of such misuse and has set a frightening precedent reminiscent of Big Brother in George Orwell’s 1984.

A law went into effect in July, 2008, requiring that any woman seeking an abortion in South Dakota must be told that she is terminating the life of “a whole, separate, unique, living human being” with whom she has an “existing relationship” and that abortion terminates “her existing constitutional rights with regards to that relationship.”

It requires that doctors give patients information about medical risks, but it doesn’t leave anything to chance: it specifies what the risks are, including depression, suicide, danger to subsequent pregnancies, and death. The current state of development of the fetus must be described, and the woman must be asked if she wants to see a sonogram of the fetus. All of this must be done in writing, and the woman must sign each page of documentation. Physicians who fail to comply can lose their license or be charged with a misdemeanor. (more…)

Posted in: Politics and Regulation, Surgical Procedures

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The $150,000 Vaccine Challenge

At the request of a correspondent from the Quackwatch Healthfraud discussion list, I recently got embroiled in a debate with a couple of anti-vaccinationists in the pages of an Amish community newspaper, Plain Interests, published in Millersburg PA. They followed the usual pattern: they told the same old lies, they told partial truths distorted out of all recognition, and they omitted all those other truths that contradict their beliefs. Then they both challenged me to take all the recommended baby vaccines adjusted for weight to “demonstrate that vaccines are safe and effective.” If I refuse to do this, they say it will show that vaccinators are dishonest and that I’m afraid of my own medicine. They said I could win $150,000 by taking the challenge.

I did a little investigating. There is indeed a published challenge by Jock Doubleday, although the exact amount of money currently offered is unclear. His challenge reads:

The offer will continued to increase $5,000 per month, in perpetuity, until an M.D. or pharmaceutical company CEO, or any of the 14 relevant members of the ACIP (see below), agrees to drink a body-weight calibrated dose of the poisonous vaccine additives that M.D.s routinely inject into children in the name of health. The mixture will include, but will not be limited to, the following ingredients: thimerosal (a mercury derivative), ethylene glycol (antifreeze), phenol (a disinfectant dye), benzethonium chloride (a disinfectant), formaldehyde (a preservative and disinfectant), and aluminum.

According to Ratbags, this offer is bogus. (more…)

Posted in: Public Health, Vaccines

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Santa Visits the Hospital

Since Val has broken the ice, I thought I would offer some more Christmas humor. The following is a Narrative Summary (a report of a hospitalization) that was circulated at the Plattsburgh Air Force hospital where I worked in 1986. I published it in my memoirs, Women Aren’t Supposed to Fly. Unfortunately I don’t know who wrote it, so I can’t give credit where credit is due.

Kringle, K. AD/Arctic AF 0-7 000-00-0000
D & T: ELF
USAF Hospital Plattsburgh, Plattsburgh AFB, NY 12903
Register number: classified.
Date of admission: 24 December 1986
Date of discharge: AMA 0100 25 December 1986

CHIEF COMPLAINT: Frostbitten tallywhacker.
HISTORY OF THE PRESENT ILLNESS: The patient is a three hundred and eight year old supernatural being employed as a stealth sleigh driver, powered by reindeer, who comes in on Christmas Eve stating that he was coming over the northern part of the Yukon Territory and, unfortunately, the fly of his pants came open, and his member was exposed to some rather cold air flowing by at rather high velocity. Unfortunately, he did not notice right at first and attempted to slide down a chimney at which point, he then scraped his member on the edge of the bricks. He now comes in appearing quite uncomfortable, and complaining of pain in his genital area. He also noted some mild abdominal discomfort, and admits to drinking large amounts of ethylene glycol earlier this evening, prior to his trip. The patient is rather vague about his trip but indicates that he really needs to be on his way, and really just wants something for his pain.
PAST AND FAMILY HISTORY: The patient gives a remarkable lack of much past history despite his age. He notes that about this time every year he does get rather anxious and occasionally requires some sedatives to calm him down. He also has occasional bouts with hemorrhoids, and was recently seen at this hospital for the same complaint while on a supply run. Family history is rather unremarkable, in fact, he doesn’t recall that he has any family other than his wife, twenty-two elves, and eight reindeer – one who seems to be constantly bothered by a red and runny nose. He is employed as a sleigh driver for the Arctic Air Force, but fails to reveal much other detail, saying he is on a “Super-Duper Top Clearance Mission.” He does claim to have recently recharged his batteries. Apparently, by that he means he had a nuclear-powered penile implant because he said even at 308 years old he still does enjoy his sexual activity, and that he just wasn’t quite as potent as he used to be.
PHYSICAL EXAMINATION: The patient has a blood pressure of 168/90. Pulse is 72, and regular. Respiratory rate is 18. He is afebrile. The patient is a rather old, jolly fellow. He is dressed in fur from his head to his foot and his clothes are all tarnished with ashes and soot. His eyes have a twinkle, his dimples how merry. His cheeks are like roses, his nose like a cherry. The stump of a pipe he clenches in his teeth, and the smoke encircles his head like a wreath. He is rather short, and has a little round belly that shakes when he laughs like a bowl full of jelly. The rest of the examination is remarkable for a rather large member. It appears to have some external abrasions, and some very mild frostbite at the tip. An eerie glow seems to emanate from his left femoral region, this is apparently his nuclear-powered implant.
LABORATORY DATA: Is remarkable for an ethylene glycol level of 38.
DIAGNOSIS: 1. Frostbitten penis secondary to exposure with some external abrasions.
  2. Ethylene glycol intoxication.
  3. Obesity, and mild gastritis secondary to number 2 and to excessive intake of snacks tonight.
COURSE IN THE HOSPITAL: The patient was admitted to the Internal Medicine Service. Surgical consultation with Dr. Costanzo was obtained, who debrided some frostbitten area. Right after this, the patient became quite agitated and signed out against medical advice (AMA) stating that he had a trip which he must complete tonight.
DISPOSITION: The patient was advised to keep his member covered for the remainder of the trip, and that we will look forward to seeing him again next year.

Signature of Physician: William Osler, M.D.

Merry Christmas to All!

Posted in: Humor, Science and Medicine

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Paternalism Revisited

Paternalism is out of fashion. Doctors used to have a parent-child relationship with their patients: they concealed the truth if they thought it was in the patient’s best interest, they dictated the treatment and did not have to justify it to the patient. “You have to take this pill because I’m the expert and I know what’s best; don’t ask questions.” Sort of like “You have to go to bed now – because I said so and because I’m the mommy.”

Some time in the 20th century we evolved to a different doctor-patient relationship, an adult-adult one in which the doctor shared expert knowledge and information with the patient and they cooperated to decide on the best treatment plan. The principle of patient autonomy became paramount and the patient gave informed consent to the chosen treatment.

It is generally accepted that this is all for the good. But is it really? In his book Intern: A Doctor’s Initiation, Sandeep Jauhar says, “Over time, my views on informed consent have evolved. I no longer view paternalism as suspiciously as I once did. I now believe that it can be a core component of good medical care.” (more…)

Posted in: Medical Ethics

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“I Reject Your Reality” – Germ Theory Denial and Other Curiosities

Note: This article was originally published in Skeptic magazine. Space limitations resulted in omitting some of what I wanted to say. I’m taking advantage of having a blog to publish the entire article as originally submitted.

——————

On an episode of Mythbusters, Adam Savage was shown a video clip that contradicted his memory of something he had said. He responded, “I reject your reality… and substitute my own.” He was joking. Unfortunately, the world is full of people who reject reality and who are not joking.

James Randi tells a story about a TV program that featured Uri Geller doing his standard trick of bending a key. Afterwards, the program’s host said it couldn’t possibly have been a trick because Uri had “never touched” the key. The host was then shown the recorded program, which proved that Geller clearly had the key in his hands, for two-and-a-half minutes. Instead of admitting having been wrong, the host exclaimed, “Well, that’s not how it happened.”

One of my own ancestors was a pro at this kind of thing. I’ll call her Aunt S (for stubborn). She had once tried tinned sardines, hated them, and refused to ever touch sardines again. One day she came into my grandmother’s kitchen when she was frying up some large fresh sardines a friend had brought her. Aunt S ate some, proclaimed them tasty, then asked, “What kind of fish were those, Mary?” My grandmother told her they were sardines. She protested, “No they weren’t! I don’t eat sardines!”

(more…)

Posted in: Nutrition, Vaccines

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Does TV Cause Teen Pregnancy?

I’ll be the first to admit that the quality of TV programming, especially network programs, leaves much to be desired. Critics of television have blamed TV for everything from violence to obesity. Now studies have shown that teens who watch sexy programs are more likely to become sexually active and to get pregnant. I’m not so sure that these studies really show what TV critics think they show. My local newspaper was equally skeptical.

We frequently criticize media coverage of scientific issues, so for once I’d like to offers kudos to the Tacoma News Tribune for publishing this editorial:

TV and teen pregnancy: A lot else is also at work
THE NEWS TRIBUNE
Published: November 5th, 2008 12:30 AM

For parents, the headline was ominous: “Study links TV, teen pregnancy.”
The article that appeared in The News Tribune Tuesday reported on a Rand Corp. study published in this month’s issue of Pediatrics magazine. Researchers say they found a link between higher teen pregnancy rates and watching television shows that have lots of sexual dialogue and behavior – ones like “Sex in the City, “That ‘70s Show” and “Friends.”
“Friends”?
The implication is that if teens watch such racy programming, they’re more likely to become sexually active themselves – and therefore more at risk of getting pregnant or impregnating someone else.
But couldn’t something else also be at work here? (more…)

Posted in: Science and the Media

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Gulf War Illness

One-fourth of the veterans of the 1990-91 Gulf War complain of persistent memory and concentration problems, chronic headaches, widespread pain, gastrointestinal problems, and other chronic abnormalities not explained by well-established diagnoses. Treatments are ineffective and symptoms do not improve over time. Gulf War Syndrome or Gulf War Illness is a controversial diagnosis, and some have questioned whether it really exists. Now a new report from the Research Advisory Committee on Gulf War Veterans’ Illnesses has concluded that Gulf War Illness is real and that it is probably attributable to pyridostigmine bromide (PB) and pesticide exposures.

Its major conclusions:

  • Gulf War illness is a serious condition that affects at least one fourth of the 697,000 U.S. veterans who served in the 1990-1991 Gulf War.
  • Gulf War illness fundamentally differs from trauma and stress-related syndromes described after other wars.
  • Evidence strongly and consistently indicates that two Gulf War neurotoxic exposures are causally associated with Gulf War illness: 1) use of pyridostigmine bromide (PB) pills, given to protect troops from effects of nerve agents, and 2) pesticide use during deployment.

The Research Advisory Committee on Gulf War Veterans’ Illnesses was mandated by Congress and appointed in 2002. The report, published November 17, 2008, is an exhaustive review of all available data, including some that is unpublished. It runs to 454 pages, has multiple authors and consultants, lists 1840 references and has multiple appendices. I can’t pretend to have mastered all the information, but I have read enough to understand the basis of their conclusions. They are based on good evidence and logic, but they leave me with some doubts.
(more…)

Posted in: Politics and Regulation

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Biofeedback and Laser for Allergies

AllergiCare Relief Centers are a chain of franchises started by a man called David Tucker who is not listed as having an MD or any other title. They offer diagnosis of allergies by biofeedback and treatment of allergies by laser acupuncture. They admit that the method is not backed by any science, and they claim that what they are doing is not medical treatment.

Responsible journalism might have investigated this as quackery or practicing medicine without a license. Instead, irresponsible journalism has helped promote these centers and has given them invaluable free advertising.

From one news story:

Tucker said the device works based on biofeedback. The allergy sufferer wears a sensing clip on his finger for testing, and the computer simulates the bio-frequency for 10,000 known allergens. As the body responds to those stimuli, the computer lists which substances are irritants. “This digitized allergen actually matches the harmonic frequency of the actual allergen, making the body believe it is in contact with the real substance,” Tucker said. “The body will react if it is allergic to the particular substance.” ….Once the allergens are identified, a laser stimulates biomeridian points on the body — the same points used in acupuncture and acupressure. Tucker said the idea is to strengthen organs to act properly the next time they encounter the allergen — that is, to treat them as harmless…So far, there is no science to prove the devices work, but Tucker claims a 70 percent positive response rate. (more…)

Posted in: Energy Medicine, Health Fraud, Medical devices, Science and the Media

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Statins Are Better on JUPITER

Over 26 million Americans are taking statin drugs. Some people think they should be available over-the-counter without a prescription, and it has even been facetiously suggested that they should be added to our drinking water. The protective effect of statins in cardiovascular disease and in high-risk patients with high cholesterol levels is well established. But what about people with no heart disease and normal cholesterol levels – can they benefit too?

The New England Journal of Medicine has pre-released an important new study on statins online prior to its planned publication date of November 20, 2008. It is certain to stir up a lot of controversy, and the International Network of Cholesterol Skeptics will not be happy, because it contradicts some of their favorite arguments. They have claimed that statins do more harm than good, that reducing cholesterol levels is harmful to health, that the benefits of statins and/or cholesterol lowering do not extend to women and the elderly, and that studies showing benefits of statins are meaningless because they do not show reduction of overall mortality. This study indicates otherwise. (more…)

Posted in: Clinical Trials, Pharmaceuticals

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Circumcision: What Does Science Say?

Some people think circumcision is mutilation; others want one even if they don’t know what it is. When I was working in an Air Force hospital emergency room one night, a young airman came in requesting a circumcision. I asked him why he wanted one. He said a couple of his friends had had it done, and he’d heard it was a good idea, and he was going to be getting out of the Air Force pretty soon and wanted to have it done while Uncle Sam would still foot the bill. I examined him: he had a neatly circumcised penis without so much as a hint of any foreskin remnant. I’ve always wondered what he thought we were going to cut off.

The subject of circumcision evokes strong emotions. Some people think of neonatal circumcision as a religious duty or a valuable preventive health measure; others think it is the epitome of child abuse. I have no strong feelings either way. I’m not sure what I would have decided if I’d had sons; fortunately my children were both daughters so I didn’t have to decide. I’m going to try to stand back and look at the scientific evidence objectively. What are the medical benefits and risks of circumcision? (more…)

Posted in: Medical Ethics, Surgical Procedures

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