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posted by martyb on Monday February 18 2019, @05:23AM   Printer-friendly
from the getting-sick-is-hazardous-to-your-health dept.

https://blogs.bmj.com/bmj/2019/02/13/richard-smith-most-devastating-critique-medicine-since-medical-nemesis-ivan-illich/

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.


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  • (Score: 2, Insightful) by Anonymous Coward on Monday February 18 2019, @08:51AM (1 child)

    by Anonymous Coward on Monday February 18 2019, @08:51AM (#802847)

    I'm not saying you're wrong, but I am saying that this type of breakthrough is nowhere near as close as it may appear if you read just the research announcements.

    To put it into computer terms, today's biomedical/cancer research is basically trying to support legacy code, that is

    * about 4 billion years of basically randomly generated spaghetti code with zero documentation

    * operating in an environment that is quite different from what the code has (new chemicals unseen before, new types of radiation, new types of social and physical stresses, etc.)

    * barely figured out.

    In other words, we're trying to fix catastrophic (GPF/OS) crash bugs in a very complicated legacy Excel 97/VBA app, running in Wine or Windows 10 Home Basic, and our level of skill so far has only reached knowing how to open a hex editor and edit the binary code directly (no "source code" to speak of.) Oh, and one catastrophic crash means we can't practice on that install anymore, can't really debug what happened, and we have to start over on a completely separate, differently configured/corrupted install of the same app.

    It may work sometimes, and this can feel very empowering and encouraging to someone who's never used a computer before, but it's nowhere near knowing what the fuck is going on and having a god-like power of full control/understanding that some specialists may give the impression of.

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  • (Score: 0) by Anonymous Coward on Monday February 18 2019, @05:24PM

    by Anonymous Coward on Monday February 18 2019, @05:24PM (#803052)

    I'm not saying you're wrong, but I am saying that this type of breakthrough is nowhere near as close as it may appear if you read just the research announcements.

    No, it is wrong. If you think there is any chance of this whatsoever tell me the odds and I will bet on it.