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Media Watch - Doctor No!
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Doctor No!
A paradigm shifts?
MEDIA WATCH with Mary Aspinwall, R.S Hom, P.C. Hom.
The old adage that “Doctor knows best” has taken
something of a hammering of late, with doctors’ actions
coming under increasing public and governmental scrutiny.
The most dramatic example of how putting total trust in a
medical professional can seriously damage your health unfolded
at the recent trial of Dr Harold Shipman. He was found guilty
of the murders of 15 elderly women in his care, using lethal
heroin injections. It was revealed in January that, although
he will not face any further charges, he might actually have
killed as many as 297 patients during his 24-year career as
a lone GP. In the midst of public outrage, Britain’s
Health Secretary, Alan Milburn, pledged to close the loophole
allowing Harold Shipman to draw his health service salary
despite the murders. The killings are also likely to lead
to legal changes for all doctors in relation to their powers
to sign death certificates and to handle drugs.
The issue of vaccination has also been the subject of much
media debate over the past year or so, with over 150 articles
appearing in the Examiner alone. It is a measure of the public’s
distrust that one quarter of children resident in Ireland
are currently not vaccinated against measles. Of all the vaccines
MMR(combined Measles Mumps Rubella) has had some of the worst
press due to evidence of a link between the jab and the soaring
levels of autism.
Dr Andrew Wakefield of London Royal Free Hospital and his
team of researchers recently presented their findings to the
US Congress as part of a debate on autism. They said there
was now compelling evidence linking autism with MMR. Autism
support groups welcomed the evidence as ‘hugely significant’.
Meanwhile the Oireachtas continues to hear evidence on MMR
and in October 2000 one of the world’s leading vaccination
experts (Dr Bronwyn Hancock, Head of the Australian Vaccine
Information Service) warned the Irish Government to be very
cautious about the continuing use of the controversial vaccine.
Asked if he would be making recommendations to Health Minister
Michéal Martin about the future use of the MMR vaccine,
Deputy O’Keeffe said: “It will all depend what
comes out at the oral hearings - we cannot prejudge what course
of action we will be taking... “.
Questions relating to the ethics of vaccination trials were
raised by a report, issued in November, that revealed tests
were carried out by drug company Wellcome at the request of
the Eastern Health Board on children in care. The children
were used as guinea pigs for the vaccine trials because the
Board was concerned about adverse reactions to the three in
one vaccine (DPT – combined Diptheria Pertussin Tetanus).
More recently it is the Polio vaccine that has been grabbing
headlines. Brussels issued warnings14 months ago that British
blood donor whose plasma had been used in the manufacture
of a batch of oral polio vaccine had since been diagnosed
as suffering from the new variant form of Creutzfeldt Jacob
Disease. Despite these warnings as late as December 2000 doses
from the suspect batch were still being administered to tens
of thousands of Irish children. Minister Micheál Martin
reassurance to parents that there was ‘absolutely no
risk’ that their children would not catch the human
version of Mad Cow Disease from the vaccine were treated with
derision by many.
Public unease about the medical professions treatment of the
dead has also been much in evidence this year. In January
pathologist Dr Dick van Velzen was banned from ever working
in Britain again. Whilst based at Britain’s Alder Hey
hospital he had systematically stripped internal organs from
hundreds of dead children, leaving their bodies as little
more than shells. Years later, many parents were trying to
come to terms with the fact that their child’s body
had not been buried intact as they had believed. One father
told how he had discovered that most of his four-year-old
son’s organs (including his heart, brain, lungs and
testes) had been removed without his knowledge or consent.
Commenting on the parallel controversy engulfing Irish hospitals
the Examiner’s editorial captured the horror many felt
following the revelations:
“It can take a lifetime for parents to come to terms
with the devastating grief caused by the loss of a baby. To
learn that organs were stripped from their tiny bodies and
stored on laboratory shelves must be an emotional experience
beyond imagining.”
British media reports detailed a series of cases where hospitals
had also sold organs to research firms who in turn donated
the money they paid back to the hospitals for improvements
in their medical facilities. The practice echoed earlier reports
of the sale of aborted foetuses to cosmetics firms.
My sense is that what we are now witnessing
is a major paradigm shift in the public’s belief system.
Trust in a medical practitioner now has to be earned rather
than given unquestioningly.
This feeling was further confirmed by two
reports. Fred Brock writing in the New York Times this February
under the heading “Talking Back to Doctors Is Good Medicine”
gave the medical profession this warning:
“ Doctors who are dismissive toward the elderly and
their problems had better brace themselves, because the baby
boomers are on the vergeof becoming the latest crop of older
patients.”
And in The Times (January 2001) even the
great and the good came out in favour of my hypothesis!: The
Lord Chief Justice called last night for a less deferential
approach by courts to the medical profession and an end to
the assumption that ‘doctor knows best’.
Public confidence in doctors had been dented by a series of
well-publicised scandals, Lord Woolf, said. In the past courts
had been excessively deferential to the medical profession
but this "automatic assumption of beneficence" had
been dented, he added.
"It is unwise to place any profession or any other body
providing services to the public on a pedestal where their
actions cannot be subject to close scrutiny," he told
his London audience. Lord Woolf called for courts to take
a more robust view of negligence by the medical profession
…
“The behaviour of those involved in betrays a lack of
appreciation of the limits of their responsibility.”
Whilst Lord Woolf accepted that they were not motivated by
personal gain, he felt they had lost sight of their power
and authority. The acted as though they were able to take
any action they thought desirable, irrespective of the views
of others.
“The over-deferential approach is captured by the phrase
‘doctor knows best’. The contemporary approach
is a more critical one. It could be said that doctor knows
best if he acts reasonably and logically and gets his facts
right."
Lord Woolf said the deterioration in confidence by the public
and judges alike was evidenced by an increase of more than
30 per cent in the number of complaints to the General Medical
Council.
"The number has risen from some 3,000 last year to a
predicted 4,300 this year. The future of the GMC has itself
been called into question."
Other factors had made judges less deferential: the difficulties
people had in bringing successful claims; an increasing awareness
of patient’s rights; the closer scrutiny of doctors
by courts in places such as Canada and Australia and the scale
of medical negligence litigation which was a "disaster
area".
This indicated that the health service was not giving sufficient
priority to avoiding medical mishaps and treating patients
justly when mishaps occurred, he said.
(My thanks to Kate Soudant for sending me the New York Times
article and to Helen de Vesey for drawing my attention to
The Times.)
Wake up call for VHI
BUPA Ireland has launched a product that will also allow patients
to reclaim at least half of the cost of alternative medicine
bills for acupuncture, homeopathy, chiropractic and osteopathy
costs. BUPA launched their comprehensive health care insurance
package, which will include cover for a wide range of prevention
and health screening initiatives. ... There is also a £700
home birth grant.
After three years on the Irish scene, BUPA claims a market
share in excess of 10%. According to chairman Dr Margaret
Downes, it has a net growth of at least 1,200 people per week.
Challenging VHI’s monopoly in an expanding market since
1997, BUPA claims more than 170,000 members on its books of
which it estimates up to 45% are former VHI members.
When asked why they did not pay a contribution towards homeopathic
treatment VHI replied that their medical consultants had advised
against doing so. Perhaps they should consider the wise judge’s
words regarding Doctor knowing best… particularly in
the light of the fact that they may not be unprejudiced observers
on this issue!
Examiner asks IMB to use common sense
“While it may be considered necessary to set up a special
arm of the Irish Medicines Board to govern the whole area
of alternative medicine there are fears that a rigorous process
of product authorisation, plus a prescription only sales regime,
will give large multi national pharmaceuticals greater dominance
of the market. It is vital that future decisions be informed
by common sense. The inclusion of alternative health practitioners
on the IMB committee marks a significant step towards protecting
the freedom of choice of thousands of consumers.” (The
Examiner Editorial, January 2001)
Promoting homeopathy
As the Society’s PRO, there are two ways I can work.
One is to be purely reactive responding to enquiries and possible
misinformation whenever I am called on to do so. The other
is to be pro-active: producing articles and presenting them
to various media for publication or broadcast.
Currently, much of what is written in the media in relation
to Homeopathy concerns how the public can use it to treat
themselves for first aid injuries and minor ailments. Such
information is very useful and may lead the public to consider
visiting a Homeopath to get treatment for chronic conditions.
I see my task as two-fold. I want to promote Homeopathy, but
I also want to promote Homeopaths. I would personally like
to see the media focus more on what homeopaths do and perhaps
less on self-help features.
Here is a nice example. It appeared at the end of an Examiner
article on exam nerves.
Many alternative techniques, like aromatherapy
can be helpful to relieve stress. And it can be self-help.
A few drops of lavender in a bath can aid sleep. Homeopathy
can be very helpful too.
Frances Bowe helped a theology student whose stress made her
blank in exams.
“I gave her a preparation called Athusa and she said
it wiped away her problem,” says Frances. “She
came first in her final exam.” She is also helping a
bright leaving certificate student whose mock results were
disappointingly bad because of her sense of panic.
“Rescue Remedy is very good,” she says. “The
students must calm down and take control for themselves. Perhaps
by being by themselves. Nobody can do it for you.”
As Frances points out, with good study skills most students
calm down after the first day.
You may also have noticed that magazines
such as Here’s Health often feature real life cases.
Here someone who has been successfully treated by alternative
means volunteers to tell their story in the hope that others
may be treated successfully. The media is happy as they have
a great human-interest story and the practice of seeking alternative
help is encouraged.
Ethical issues relating to publishing homeopathic
cases in the media
By the time you read this, the new code of ethics may have
been accepted by the EGM in Galway. If it has, publishing
such cases may be considered to be in breech of the code.
If the code has already been accepted amendments are possible.
My feeling is that such cases should be actively presented
to the media provided the following rules are strictly adhered
to:
Both the client and homeopath have rights
No pressure should be put on clients to give permission for
their case to be published
Clients and homeopaths can opt to be either named or anonymous
The patient should be given the opportunity of reading the
text in full prior to any publication
Written agreement to publication should always be obtained
from clients
To avoid any danger of misrepresentation
each individual article should make clear that:
The client was treated, not the disease
Prescribed remedy ‘x’ is only one of hundreds
of possible choices for condition ‘y’
The nature of the prescription given was holistic
Serious or chronic conditions should always be treated by
a qualified Homeopath
No claim is being made in relation to the ability to cure
a particular condition
Ideally I would like to set up a bank of
short, well presented cases where clients are prepared to
go on record.
Let me know what you think…
Send your thoughts and media contributions
to:
Mary Aspinwall
2 O'Rahilly Street
Clonakilty
County Cork
Telephone/Fax 023 34748
e-mail: mary@homeopathyworld.com
(My thanks are due also to The Examiner
for their excellent on-line archive service www.examiner.ie
For the next issue I plan to take a long look at The Irish
Times archives on www.ireland.ie
)
©Mary Aspinwall
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