The Guardian, Times and BBC are today reporting that National Heath Service funding for homoeopathy is on the decline. A survey conducted by Pulse has found that only 37% percent of the UK’s primary care trusts are still funding homoeopathy services, with more than 25% having reduced funding to homoeopathy in the last two years.
The real news, I would argue, is that more than a third of the UK’s funding bodies are still funding the alternative medicine.
The BBC
reported yesterday that the inability of
some people to get out of bed in the morning is genetically determined. A study at the University of Zurich
found that individual cells have ‘clocks’, which regulate body processes. The schedule of these clocks determines whether one is better suited to early mornings or late nights.
When a pattern of behaviour is found to be
biologically based, those who exhibit it often find themselves excused from
responsibility for it, particularly if it is correctable. It is not the fault of dyslexics that they
make mistakes reading and spelling, and it is not the fault of Tourette
syndrome sufferers that they make offensive remarks. As a result, medical help is provided for
sufferers of these conditions. Sometimes, however, the view that those who exhibit undesirable,
biologically-determined behaviour should be excused from responsibility for it,
and their behaviour medically corrected, is controversial. For example, many view the widespread
prescription of Ritalin to treat attention-deficit hyperactivity disorder
(ADHD) in children as suspect, in part because it encourages the view that
unruly but normal children are diseased, and therefore excuses those children
and their parents from applying discipline to reign in the offending behaviour.
Read More »I won’t be coming to work today – I’d rather go back to sleep
Last Friday’s issue of Science contained a paper announcing the creation of a synthetic chromosome by a team of scientists headed up by the biologist and entrepreneur Craig Venter. Venter is a very controversial figure. He was described as the ‘bête noire of the scientific establishment’ by Colin Blakemore in an article that appeared in The Observer on Sunday. Blakemore calls for a public debate to establish a regulatory framework for research on synthetic life. He suggests that in the absence of such a debate we may see legitimate concerns about the risks of synthetic life hijacked by religious organisations, such as the Catholic Church, who worry about scientists ‘playing God’. And religious organisations are not the only organisations that have had an emotional response to synthetic life. The Canadian biotechnology lobby organisation, the ETC group, who call for a moratorium on the release and commercialisation of synthetic life forms have a comic strip, prominently displayed on their website, which ends with the birth of Synthia, a ‘new species of bacterium with entirely human-made DNA’, replete with an evil-looking face and little horns on its head.
In the last month there have been a number of cases of patients with terminal cancer appealing for access to novel drugs that are not currently funded under the NHS. In Scotland yesterday a man with terminal bowel cancer succeeded in his battle to get NHS funding for a new and expensive drug cetuximab. This follows the recent publicity over two patients with breast cancer who have been fighting to be allowed to pay privately for another new drug bevacizumab.
These drugs are genetically engineered antibodies developed by a US biotech company to target growth factors commonly found in tumour cells. The drugs have been shown to improve survival of patients with some cancers, but evidence is lacking in other types of cancer.
This sort of dilemma is not unique to the UK. There is similar debate about access to bevacizumab in Canada and Australia. Some of the debate is about the science, and whether or not the drugs have been conclusively proven to be of benefit. However there are also ethical questions about the rationing of expensive treatments in public health care systems. It is generally accepted that there are finite resources available for healthcare, and that not all treatments can be afforded. But if public funding isn’t available for health treatment should patients be able to pay privately to access them?
Read More »Paying for better health: Should patients be able to pay for expensive cancer drugs?
Earlier this month, Gordon Brown, writing in the Sunday Telegraph, voiced his support for a presumed consent system for post-death organ donation in the UK. At present, organs may be procured from a dead body without the family’s consent if the deceased had actively opted-on to a national organ donation register. Under a presumed consent system, all would be included on the register unless they had actively ‘opted out’.
Objecting to Brown’s proposal, the economist and journalist Irwin Stelzer writes in the Telegraph this week:
90 per cent of us favour organ donation, but only 25 per cent make advance arrangements to become donors. From that, the opt-out advocates conclude that most of the non-donors are merely negligent: they forget to register. Really?
It is equally plausible that non-participants have no objection to the procedure, but simply do not want to participate, just as many (most) people have no objection to elections, but choose not to participate, for reasons sufficient unto themselves.
This objection strikes me as unpersuasive.
The distribution of research funds is clearly
not based on purely objective criteria. Most countries have different ways of
how to deal with this issue – all face different, but serious problems. Bruce Knuteson (MIT)
has developed a formula of
which he claims is able to estimate the scientific merit that a proposed
experiment will give back per monetary unit before
we actually perform it. Knuteson’s formula
estimates the gain to be obtained by a proposed experiment in terms of the reduction in information entropy the experiment is
expected to provide. This is a seductive concept: Large scientific projects,
think of ITER at Cadarache or the Large Hadron Collider at CERN – cost the public a lot of money. The ‘right’
distribution of research money is thus not only of interest to promote the future success of
scientific research, but also of larger societal interest. The Swiss newspaper Neue
Zürcher Zeitung (NZZ) reports on Knuteson’s formula. Can it really help to
provide objective and rational criteria for funding the right type of research?
Read More »Objective Research Funding? An Approach to quantify the Value of Experiments
Swedish athletes Carolina Klüft and Stefan Holm (currently reigning Olympic champions in the heptathlon and high-jump events) recently suggested that elite athletes might have an obligation to implant chips or carry GPS transmitters in order to allow anti-doping organisations to track them. Meanwhile medical researchers debate whether patients should be tagged implanted chips for identification purposes. While such suggestions almost universally provoke a shudder and remarks about Orwell’s 1984 other people voluntarily chip themselves: some to access nightclubs, others to "hack" themselves. We might resist some privacy invasions, but eagerly invite others. Should we just get it over with and let the government tag us all?
Read More »I’m Not a Number; I’m a Human Being: RFID Tags and Our Personas
Research published this week in the British Medical Journal shows that babies born by elective caesarean section are more likely to have breathing trouble after birth. This is especially the case for babies who are mildly premature (1 to 3 weeks early).
These results are important, since the rates of elective caesarean sections are high in the UK (as in many countries). These rates are higher in middle class mothers, a group that has been labelled “too posh to push”. But how should doctors respond to a request for a caesarean section by a mother (where there is no medical indication)? Do the increased risks of caesarean section justify placing restrictions on maternal choice?
Read More »To push or not to push? Choosing to deliver by caesarean section.
Last Saturday, people in Germany, Austria and Switzerland were asked to switch off the lights for five minutes between 20.00 and 20.05. “Lights out! For our Climate!” was the motto. Similarly, on February 1 this year – the day of the publication of the latest scientific report of the IPCC – people all over the world followed a call of a French initiative to turn off the lights for five minutes. The recent call to arms was widely supported by the German-speaking media, including the internet portal Google.
Luckily, not too many people followed the call. Luckily, not because I want to doubt that present forecasts on the future climate provide a need to worry – they clearly do! But had 10,000 homes participated in the campaign, then it is likely that the the Power supply system would have broken down – in all of Europe. Hopefully the worries of the power generators will have been heard the other side of the Pond, when the campaign “Lights out in America" calls for a similarly rash reaction to global warming in March 2008.
These campaigns do not seem to be the only hasty reaction to global warming.
A couple of months ago, James Watson – who, together with Francis Crick, was awarded the Nobel Prize for deciphering the double helix structure of DNA – claimed that black people are less intelligent that white He invoked the authority of science to make his claim. Of course, if the claim had simply been that on average (say) African-Americans had lower scores on IQ tests than White Americans (and that this difference was reflected in educational achievement and other socioeconomic indicators), Watson would simply have been citing facts. The controversial part of Watson’s claim was that the difference was rooted in the genes of blacks and whites and therefore fixed. The first part of the claim is (probably) false – the genetic differences between blacks and white are largely skin deep. But even were it true it would be irrelevant to the real question. Watson calls himself ‘gloomy about the prospect of Africa’, because he thinks that ‘genetic’ means ‘fixed’. But ‘genetic’ does not mean ‘fixed’; the fact that the differences between two individuals are explained by differences in their genes has no implications whatsoever about how hard or easy it is to eliminate the difference. Differences rooted in environmental factors (to the –limited – extent to which it even makes sense to separate environmental factors from genetic) may be easier to eliminate than those rooted in the genes, or they may be harder. Genes work like sets of switches, under the control of other genes and environmental factors. These sets can be configured differently to produce very different results; changing a few triggers thereby produces very different products from much the same genes. In any case, the evidence strongly suggests that this particular IQ deficit is remediable.
