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from the getting-sick-is-hazardous-to-your-health dept.
Seamus O'Mahony, a gastroenterologist from Cork, has written the most devastating critique of modern medicine since Ivan Illich in Medical Nemesis in 1975. O'Mahony cites Illich and argues that many of his warnings of the medicalisation of life and death; runaway costs; ever declining value; patients reduced to consumers; growing empires of doctors, other health workers, and researchers; and the industrialisation of healthcare have come true.
[...] Unlike Illich, who believed that modern medicine counterproductively created sickness, O'Mahony does see what he calls a golden age of medicine that began after the Second World War with the appearance of antibiotics, vaccines, a swathe of effective drugs, surgical innovations, better anaesthetics, and universal health coverage for most of those in rich countries. It ended in the late 1970s, meaning that O'Mahony, who graduated in 1983 and is still practising, enjoyed little of the golden age. We are now "in the age of unmet and unrealistic expectations, the age of disappointment."
[...] O'Mahony begins his dissection with medical research, "the intellectual motor of the medico-industrial complex." Governments see life sciences as a saviour of economies, and charities urge us to give more to cure every disease. Big Science, which appeared after the golden age, has provided jobs and status but "benefits to patients have been modest and unspectacular." A study of 101 basic science discoveries published in major journals and claiming a clinical application found that 20 years later only one had produced clinical benefit. Big Science is corrupted by "perverse incentives, careerism, and commercialisation."
[...] No disease is better marketed than cancer, and after Richard Nixon's War on Cancer, Barack Obama launched his Cancer Moonshot, which is now renamed Cancer Breakthroughs under Donald Trump. As O'Mahony writes, the language around cancer "is infected with a sort of hubristic oedema." For Big Science cancer is a blessing, leading to huge investments in molecular biology and genetics, but, as cancer researcher David Pye put it: "How can we know so much about the causes and progression of disease, yet do so little to prevent death and incapacity."
[...] "The medical profession," he writes, "has become the front-of-house sales team for the [drug] industry." He argues that "doctors' professional culture obliges them to do something—anything," but he is too easy on doctors, who could push back. Society, he says, displays "childishness" in going along with these expensive treatments: "we must have higher, and better, priorities than feeble, incremental and attritional extension of survival in patients with incurable cancer."
[...] The first thing that I ever had published in a medical journal was a letter to the Lancet in 1974 asking why there had been no response to an article in the journal by Ivan Illich describing in detail how modern medicine was a threat to health. (It would cost me $35.95 today to access the letter, about 50 cents a word from memory.) As a medical student I expected that the leaders of medicine would carefully dissect Illich's argument and with evidence show him to be wrong. But such a response never came. I was naive: I know now that it's easier simply to ignore cogent criticisms. I hope that O'Mahony's book, a Medical Nemesis for 2019, will not be ignored. It deserves to be taken very seriously.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @08:45AM (1 child)
None of those anouncements are about "cancer", they're about specific forms of cancer. Helpful to some people, but not many and who knows how many are every fully developed and actually create a tangible benefit?
(Score: 2) by HiThere on Monday February 18 2019, @05:49PM
To an extent you're definitely correct. Cancer is not a disease, it's a syndrome. A collection of similar symptoms that are called by a common name. So curing one variety doesn't necessarily, or even probably, cure the others. Another example of that is the common cold, which is sometimes one of a number of different viruses, and sometimes an allergy.
But curing one kind of cancer cures that kind of cancer, and then you can address the next kind. Some kinds are known to be "caused" by viruses. (It's not clear whether the virus actively causes the cancer, or whether it just acts as an initiating agent, but if you could eliminate the virus, you'd eliminate the cancer, or at least retard its initiation by decades. And again, don't assume all of the viral cancers are identical. For that matter there's a couple of animal cancers that are known to be directly contagious. A genital one in dogs and a facial one in Tasmanian Devils. So there may be human cancers that are also directly contagious.)
As a result, all this "War against Cancer" stuff is drastically oversimplified. Try to explain it in detail and people go to sleep on you, even though it's a matter of life and death. But the clear implication is that if you want to model it with a war, a closer model is a guerrilla war than one with formal armies. And even so it's a lousy model. But progress has been made, and is being made. And it's almost guaranteed to continue to not be better than incremental.
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