VIEWPOINT:WHAT WE’RE DOING IS RIGHT

When I read the medical literature, I wonder why on earth anybody bothers carrying out medical studies.

There is, first, the fact that doctors have known since the Fifties that using chloramphenicol, an antibiotic, used as a topical antibiotic for eye infections can cause bone-marrow suppression (p 7). Forty years they’ve known this drug can be fatal. Nevertheless, this drug is still the drug of choice in Britain for benign problems like “red eye”, even though it is the court of last resort in America.

America has its own share of practices carried on blithely even after they’ve been utterly demolished by scientific evidence. Every study of prostate screening blood tests show they are so inaccurate as to be less than useless. Nevertheless, every American male over 50 is now supposed to line up for his screening test. If it proves positive, most tumours are now automatically removed, even though most studies show worse survival rates and quality of life with surgery than without it (p 1) .

Then we have a new (and little publicized) study that HRT used for 10 years can increase ovarian cancer risk by a whopping 70 per cent for women who use it for a decade or more (this page). This struck me as an astounding finding for a drug whose raison d’etre, increasingly, is long-term use in order to prevent osteoporosis. Indeed, up until now, doctors have been maintaining that HRT prevented ovarian cancer. Nevertheless, this little tidbit was brought to my attention by none other than the PR company promoting a new HRT preparation. But of course that’s only about the old type preparations, she said. She showed it to me only to distance this “bad news” from the new drug her company was promoting.

Finally, we have the vitamin K debate (p 8). A study showing a link between injected vitamin K in newborns and a doubled risk of leukemia was worrying enough for the Department of Health to cautiously recommend that doctors now use the oral variety. Nevertheless, these sober warnings may not have been adopted by the rank and file. One reader sent in a leaflet from two consultants of St Thomas’ in London, who continue to defend injectable vitamin K to their patients.

“We do not think that it does prove that vitamin K injection causes cancer in children, ” they boldly assert, not offering much in the way of supporting evidence. First, they say, the introduction of intramuscular vitamin K in the US wasn’t associated with an increase in leukemia (to my knowledge, this widely used fact has never been subjected to a proper study); second, it’s just not possible because we can’t figure out how it could (“it is difficult to see how the injection could cause cancers”); third, if it does turn out to be true, most of these cases of cancer “could be successfully treated.” In other words, even though your baby could be at higher risk of a fatal disease with the shot, we can probably cure it. Their argument works if medicine can always cure cancer, which thus far it has singularly failed to do.

Doctors believe so fervently in the power of their tools that they are willing to suspend all reasonable scepticism about current and new medical treatments so long as these treatments fit in with orthodox medical assumption. Most doctors and researchers operate on the assumption of a priori benefit, whether or not a given remedy has actually been proven. It’s the reason they don’t need medical studies to prove or disprove their practices. We know what we’re doing is right.

!ALynne McTaggart