The McMillian Cancer trust has published a report described on the radio as I drove to Manchester this morning as a damming and shameful report about the NHS and discrimination. The report alleges that more than 14 thousand elderly cancer sufferers are allowed to die in the UK because of age based discrimination.
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You can tell libertarians from the sound they make: it’s the faint rattle of a tiny intellect untethered in an otherwise empty mind.  Cheap and all-too-easy insults aside, though, I’d been wondering how long it’d be, in the wake of the BMA’s recommendation that smoking be banned from cars, before we got a response from the libertarians.  The answer, it seems, is a couple of days.  The Libertarian Alliance, for example, has had a go (it’s a totalitarian tax ruse, I tells ya!  Thank goodness tax is low on tinfoil hats…); but the example that really caught my attention – by which I mean rendered me slack-jawed in amazement – was this piece by Rob Lyons in Spiked, the online journal of choice of the bewildered. more…

Today’s dose of righteous anger comes, via Ophelia Benson and Marie Myung-Ok Lee writing in The Atlantic, from the fifth annual Congress on Aesthetic Vaginal Surgery, held just outside Tuscon at the end of last year.

The affable organizer of the Tucson event, Dr. Red Alinsod, was an early entrant into cosmetic-gyn, and is recognized for inventing the procedure in which the labia minora are completely amputated to create a “smooth” genital look known in the field as “the Barbie.” Though he began his career by winning a prestigious fellowship in gynecology-oncology at Yale in 1990, Alinsod now spends his days making genitalia “look pretty” for the wealthy patients who flock to his Southern California practice from all over the world. He is also an evangelist for the field, spreading its lucrative gospel to fellow doctors tired of toiling in the time-intensive and high-liability fields of traditional obstetrics and gynecology.

Cosmetic gynaecology, it appears, has been pretty much rejected by mainstream medicine – which means that it’s all-but-unregulated.  It’s a deeply weird business, though.  Actually: scrub that.  It’s really rather sinister. more…

I’ve set my RSS to receive updates from Secondhand Smoke, which is one of the blogs at First Things.  It’s written by Wesley Smith, who is affiliated to the Discovery Institute, the creationist thinktank in Seattle: that gives you an indication of the sort of position he occupies – not just on bioethics, but also on global warming, socialised medicine and probably a lot else – so it’s no surprise that I disagree with a lot of what he posts.

I mention this now because I’m currently thinking about the way that euthanasia, and medical killing more generally, get represented in the media, and I’m interested in how the blogosphere handles it.  My general hypothesis is that a lot of the coverage is distorting, and is so in a way that harms public debate, and causes unnecessary fear among vulnerable groups.  (I mentioned my suspicion here a while ago.  For the record, I don’t think that the anti-euthanasia lobby is uniquely open to criticism here, either: the defenders also sometimes seem to have a habit of focusing on isolation, indignity and so on as being inescapably the overwhelming and plainly undesirable characteristics of certain lives, particularly among the old and disabled, such that not considering death is seen as bizarre.  Though I’m sympathetic to the legalisation of euthanasia, I think it’s possible to overplay a good moral hand.)

A recent post by Smith is a nice illustration of what I mean (and suspect).   more…

“I’ve never read a more outrageous job advert,” says a colleague’s Facebook update, in reference to this from Georgetown University.

Georgetown University is seeking outstanding candidates for the position of Director of the Center for Clinical Bioethics at Georgetown University Medical Center (CCB).  The CCB Director will report directly to the Medical Center’s chief executive officer, the Executive Vice-President for Health Sciences and Executive Dean of the Georgetown University School of Medicine.  The Director will ideally possess an MD or equivalent medical training with additional graduate training in theology and/or philosophy.  The Director must have an international reputation for scholarly and professional achievements, along with a strong commitment to the advancement of the humane, theological, philosophical and ethical dimensions of medicine.  The Director should command the respect of peers from a variety of religious and non-religious backgrounds, demonstrate dedication to interdisciplinary, inter-religious and cross-cultural dialogue, possess a deep knowledge of the Roman Catholic tradition of medical ethics and  a commitment to the Ethical and Religious Directives for Catholic Health Care Services, and be a strong advocate of and spokesperson for the Catholic/Jesuit tradition in healthcare.

I’m not sure it’s as outrageous as all that, and the ad does go on to say that

Georgetown University is an equal opportunity, affirmative action employer, and does not discriminate on the basis of race, sex, sexual orientation, age, religion, national origin, marital status, veteran status or disability.

The not discriminating according to religion bit is a bit curious, admittedly – I mean, I’ll accept that a Hindu could carry out a role that involves advocacy “for the Catholic/Jesuit tradition in healthcare”*; but a Catholic is likely to have an advantage on this front.  (And what is it with veterans?  I know that Americans take the military Very Seriously Indeed; but, really – it’s just a job, albeit a job with abnormally high levels of shouting.)

But there is a couple of further questions that the ad raises, albeit short of causing outrage. more…

When Nadine Dorries MP was elected to the Commons Health Select Committee, eyebrows were raised.  But, hey – she’s an ex-nurse, so perhaps she could be relied on to have at least some sort of insight into matters relating to health (even if she does think that a foetus is capable of reaching out of a uterus to shake hands with members of a surgical team).

I happened to follow a link to her blog – completely by accident, I assure you (it was via one of those bit.ly proxies: honest) - and found that she’s very excited about the amount of time that some people spend tweeting, especially if they happen to be Labour supporters and/ or on disability benefit. more…

You need to have registered to read the BMA News, and that would seem to require BMA registration – which is a shame, because I heard a rumour of a rantable letter that appeared there in June.  A reformed medic friend has been good enough to copy and paste it for me.  The rumour’s true.  I’m not going to name the writer here, but, if you have access, the original won’t be difficult to find.

Brace yourselves.

Different ways to save lives
Lisa Pritchard informed us that in England and Wales there were 189,100 terminations of pregnancies in 2009 (‘DH reveals dropping abortion rate’, May 29, 2010, page 3).

In the same period there were around 3,000 road deaths in the UK.

The government spends a budget of about £36m per annum on road safety education and a further £135m on road safety schemes via local highway authorities – around £1m per 20 deaths.

I wonder how much is spent by government to reduce the annual abortion carnage in this country that is more than 63 times greater than that from road deaths?

Hmmmm.  I wonder.   more…

Here’s a short story about the evolution of modern science: we used to understand very little about the world, and lacked the means to understand it.  But we wanted to know how it worked, and we invented things like gods and demons to explain phenomena.  As we gradually learned more and more about the way the world works, the god-and-demon beliefs got ditched and replaced by better – that is, more truth-tracking – beliefs.  Some of these truth-tracking beliefs were actually true, too.  Sometimes this progress is halted or even temporarily reversed, perhaps as a result of poverty or trauma – think of the widespread belief in witches in parts of West Africa – but the trend is to abandon the supernatural; and the supernatural has no place in modern medicine.

The story is a bit simple, and a bit simplistic, but it’s the kind of thing that a lot of people accept as being, at least in essence, correct – and trivially correct.  Sophisticated people don’t do demons; we know there’re things we don’t know, but that’s why we have science; and the fact that we don’t know why x happened doesn’t warrant the belief that the spirits did it.

Why am I rehearsing all this?  Well, because Asleepius over at Religion versus Medicine has drawn my attention to a fairly remarkable document on the Christian Medical Fellowship’s website that appears to take seriously the idea that demons might well play a part in explaining some disorders, particularly in psychiatry.

No, really.  Look: more…

Roe v Wade ensured that women in the US had a constitutionally-guaranteed right to abortion protection from interference in decisions to terminate their pregnancy.  What it didn’t do, though, was ensure that women could access an abortion easily.  This means that there’s a number of means by which laws can be passed that make it extraordinarily difficult to access abortions, and which are still within the letter of the law.  A Bill in Ohio a couple of years ago, for example, required that the father’s approval be secured, even when the father was unknown. 

Oklahoma is in the prosess of dealing with a clutch of bills that will, stricto sensu, maintain a woman’s right to an abortion, but which also disincentivise it.  The NPWF reports that

One bill (HB 2780), approved 35-11, would require a woman seeking an abortion to undergo an ultrasound within one hour before the procedure and listen to an explanation of the ultrasound’s findings. The bill would require doctors to use a vaginal probe in cases where it would provide a clearer picture of the fetus than a regular ultrasound. Another bill (HB 3075), approved 39-6, would require abortion clinics to post signs stating that women cannot be forced to undergo an abortion. In addition, the Senate voted 35-11 for a bill (HB 2656) that would prevent so-called “wrongful life” and “wrongful birth” lawsuits. All three measures now go to Gov. Brad Henry (D). The two other bills the Senate approved Monday now return to the state House. One measure (HB 3284) would require women seeking an abortion to provide detailed information that will be posted without their names on a state-run Web site. The bill would require women to provide information about their marital status, education level, method of abortion, reason for abortion, means of payment and previous experiences with abortion or miscarriage. The bill was approved 35-10. The final bill (HB 3290), passed 35-11, would ban coverage of abortion services by plans participating in the state insurance exchanges to be created under the recently approved national health reform law.  A lawyer for the Center for Reproductive Rights said that if the bills become law, Oklahoma would have some of the nation’s strictest abortion requirements

It seems fairly obvious to me that these bills are all pretty much utterly indefensible.  The ultrasound requirement, though, catches my eye as being a uniquely odious member of this generally distasteful group, both in its content (requiring as it does that women have an unnecessary and potentially invasive medical procedure as a condition of accessing another, quite different, procedure) and its form (which is a licence for emotional blackmail).  The provision that the woman can look away from the monitor is a sick joke – she can’t help but to hear the medic describing the foetus; and that this is all dressed up in terms of providing for fully informed consent is beneath contempt.

It looks like Oklahoma may soon be the state where you’re allowed an abortion, but only if you accept as a quid pro quo a regime of physical and emotional violation, moralistic hectoring, and administrative obstruction.

One of the most galling political sights of the last few months – and there’s been quite a range – has been the slow collapse of the Advisory Council on the Misuse of Drugs in the wake of the Nutt farrago.  Ever since David Nutt had the temerity to bring facts to the table in respect of the risks of Ecstasy, the Council has been firmly in the sights of the tabloid press, and – by extension – in the sights of sundry MPs as well.  Predictably, there’s been a wave of resignations since Nutt.

Shamefully, the Government has utterly refused to come out in support of the scientists on the Council; it’s been playing a fairly blatant game of follow-the-headline.

Well, the slow evisceration of the Council continues: more…