Fuck Doctors

[slomo]

slomo wrote:
I have a few bones to pick here, out of an interest in precision.

compared2what? wrote:
Pharma is evil, corrupt, dishonest, criminal and dangerous.

<snip>
And, as far as I'm concerned, it is such a a blanket statement that it should not be accepted in its entirety without serious qualification, anyway.
<snip>
As someone in the business, somewhat tangentially but still close enough to observe what goes on regularly, I would say that the standards are taken very seriously and adhered to much of the time. The "abundant proof" consists of a few high-profile egregious cases along with meta-analysis that documents the usual failings of all scientific research, namely publication bias that results from a reward system that penalizes null results, as well as routine conflicts-of-interest which, at least from an institutional perspective, are taken seriously. I'm not saying the business is pristine - far from it - but if we are being precise then it stands to reason that we need to take pains not to oversimplify and demonize.

slomo, with all due respect, "much of time time" is simply inadequate, especially in this relation to pharmacological research and human testing, perhaps even grossly so.

Unless people like you, researchers on the inside come forward and reveal those failings, we on the outside pay the price and remain oblivious until tragedy strikes. And you seem to have excluded the true objects of your research, the human patient. But it is fair for you to report from your limited area of experience behind the scene, in the lab.

And to say that c2w? has oversimplified and demonized an industry that kills, maims and institutionalizes many people while seeking a better solution is unfair. There is plenty of anecdotal evidence and many, not a few, well documented "high-profile egregious cases." Of course there could be many more well known egregious cases if only the big pharma didn't demand non-disclosure in their settlement with those they've harmed or their survivors. After all, their primary purpose is not healing patients, but profiting from maintaining them on their drug.

As far as the practice of medicine goes, and I speak only from my own experience, it's atrocious. Yes, there are good doctors, but the profession (I use that word reluctantly) too often defends bad doctors rather than cast a cloud on their profession by ousting them.

And let's not forget or a moment that medicine is a "practice." Some do practice better than others. And some lie and some cheat.

I've had horrible experiences with most of the doctors I've dealt with throughout my life. Having some understanding of medicines and proper treatment of patients, (I studied to become a nurse), makes dealing with uniformed doctors even scarier than it does for one from the general population.

Recently, in December, a friend suffered a series of three unrelated ischemic strokes and wasn't administered heparin for 19 days into his hospitalization, after he had suffered yet another. Because his epiglottis and larnyx had been paralyzed his ability to swallow and his speech was negatively affected. He was given a tracheotomy and put on a ventilator and was receiving nutrition intravenously and via a naso-gastric tube. Years before he had undergone a Whipple surgical procedure and later developed diabetes and afterward also suffered from several hernias. Because of this his doctors at first decided it was best to stay away from compounding his troubles by surgically implanting a feeding tube where his duodenum had been and stick wtih the NG tube. But for some odd reason after his last stroke they decided to go there. During the procedure they hadn't noticed they had ruptured his intestine until the next day when his became septic with a raging fever. This is a teaching hospital and a local trauma center. Needless to say, he won't need to worry about his kids being provided for after his passing.

Another suit dealing with the maltreatment of another patient treated by this institution was just settled for a few million. He had a non-cancerous brain tumor removed and was released with a high temperature suffering from pneumonia.

Questionably, my own worst experience was when I broke my back. I suffered a double spondylolitshesis with a 40% anterior shift and three crushed discs. I was never told I had severely broken my back and he released me to return to my job as a structural steel ironworker. It was only some three years later that the insurance company's doctor explained that I had not strained my back when I was injured, as I had believed.

Oddly enough, During the time of the Reagan administration I also had tree ribs broken at the annual meeting of the American Medical Association, when I entered the assembly hall through the wrong door with an invited guest. ( to be fair, I did have a hoard of angry elderly folks with me, all wearing surgical masks and waving their four-footed canes in the air. Being an organizer, we were there to protest the AMA's support of Reagan's budget. We had already mobbed the main entrance when I had the bright idea of finding an alternative entrance. I did. It was a side entrance down in front, right by the physician studded dais. I got nailed; straight-armed by a line-backer security guard)

Lots of doctors suck, but there are a few good doctors. If you ever come across a good one, please let me know.

I can't presume to argue with your own bad experiences. However, I have had great doctors (although I admit I have not needed much medical attention, comparatively, and will concede that early in my childhood I received some bad medical advice that my family and I avoided heeding). My ex-partner's life was saved by cutting edge medical treatments, treatments that would not be available without and R&D process that I feel is being mischaracterized at the moment. A close family member is now suffering profusely because of a bad medical decision, but I am keenly aware that the decision was made with the best available information at the time. We forget that it is easy to look back in hindsight, with more information, and say what should have been done, but in the moment when split-second decisions must be made, physicians often do their best under fairly significant systemic stresses. So I really have to disagree with the blanket statement.

If you want to argue that pharma pushes drugs inappropriately and has attempted to create a system where pharmaceuticals are the first course of action in any medical situation, no matter how trivial - I will sign my name to that. If you want to argue that medical research can be corrupt, I will agree. If you want to argue that we as a society would be better off looking at prevention, at creating a socioeconomic system that allows people to lead balanced lives with adequate rest and nutrition free from toxic exposures and occupational dangers, I will completely sign off on that. But I don't think it's appropriate to condemn an entire profession filled with people who sought out in life to alleviate suffering, and who toil under great pressures in order to achieve admittedly mixed results.

I should mention that most of my knowledge comes from cancer research where - let's face it - the odds of improving outcomes at least somewhat are reasonably high (owing to the dismal prognosis if the disease is left untreated, for most cancers). Psychiatry is a whole other ball of wax.

[Iamwhomiam]

Perhaps I should not have omitted mentioning that there are also good and well meaning researchers, working honorably for noble causes too. However, noble as your cause is, I stand by my comment and think any wise person can discern that there are many fields with such good souls working honorably for good and noble causes, though their employer's are corrupt.

On edit:

I should add that if I collapse tomorrow, I hope to see a doctor and that the medicine he administers will be helpful. I'll chance the odds. Whom else do I have to turn to when in such need? As one who suffers from chronic pain, I know how morphine has helped me function. I no longer take pain medications, except on rare occasions... sort of a self-hypnosis sort of thing. Did I mention that they locked up my pain management doctor, the president of their national association, and stripped him of his license to practice medicine?

Yes, If I have some sort of infection I'll go to a doctor only to be prescribed antibiotics. Without health insurance my last visit some six years ago cost me nearly $300. $200 for the visit and another $70 for ten day supply of meds. I am thankful such medicines are available, as I am sure others being helped by physicians are when their doctor correctly prescribes for them medicines that help them.

I don't trust auto mechanics either, but that's another topic for another day.

[compared2what?]

80 Percent of Suicide Victims Took Antidepressant Drugs

Just another anecdote, but interesting:

A longtime friend, a neighbor across the hall, shot himself a few years ago. He had recently started an antidepressant regime, which I suspect of sending him over the edge. When the police came, they asked me if he had been 'into drugs'; he wasn't, but I did mention the antidepressants. At the word "antidepressant," the interview was over: "Ohhhhhhh, okay," the policeman said, already turning around with a 'say no more' wave of his arm. "Those things make people do some weird things."

I took this as significant, coming from a guy who has doubtless investigated many such deaths.

Doubtless.

Suicide Rates in the United States by Age Group, 1970 -- 2002

SSRIs were introduced in 1989. But I wouldn't want to be misleading. The text that goes with that chart doesn't attribute the overall decline in suicide rates in the subsequent time period to that. However, if anyone wants to read it or check the authors for suspicious associations with pharma or something like that, they can do so here.

What they do say -- and this is probably more than enough to sink their credibility here -- is that the data linking SSRIs to an increased risk of suicide is equivocal. And you know what? I don't know why I'm even bothering to say this. But fwiw, while it's obviously better to err on the side of caution, as far as I've ever been able to tell, that data actually is equivocal, owing to the stone obvious difficulty of determining whether the suicidality of someone being treated for depression was due to the treatment or due to the depression. I mean, that's just inherently not an easy thing to establish, statistically.

FULL DISCLOSURE: Not that anyone listens to me when I say this stuff, but ffs: "Equivocal" means equivocal, not "bogus" or "valid." I'm glad there's a black-box warning for adolescents. There should be. Apart from that and the erring-on-the-side-of-caution thing, I just don't know.

[bks]

bks --

Except that we evidently don't understand one another, as far as I can tell we agree that:

* Pharma is evil, corrupt, dishonest, criminal and dangerous.

* There's no guarantee that drug trials ever adhere to acceptable scientific standards and abundant proof that they regularly don't, which is a fucking outrage and crime, given that issues of life and death are at stake.

* It's a horror and abomination that even people who can afford to get medical treatment mostly get a ten-to-twenty minute office visit and some pills for virtually every fucking condition, disorder, complaint and syndrome there is, both psychiatric and non-psychiatric, which they may or may not actually have.

* It's also a horror and an abomination that the only major categorical exception to that is a partial one -- ie, people with pretty good access to sorta decent medical care who suffer from something in the large class of unmistakably very debilitating and/or terminal illnesses that it's lucrative to treat over the long-haul -- for at least two reasons: (1) It's partial; and (2) quite a few (though not all) of the illnesses in that category mightn't have been so debilitating or life-threatening ultimately if they'd been detected early on one of those ten-to-twenty minute office visits.
.

we do agree on all of this, and even much more, I imagine, including at minimum:

*Categorical denunciations of the use of pharmaceuticals or of psychiatry are foolish and prone to significant inaccuracies;

*There are plenty [probably a strong majority] or people working within the pharmaceutical production and delivery system, as well as the larger medical system [and for that matter, EVERY large public-serving institutional system in US society], who are not only highly competent, decent human beings, but who are tireless workers motivated in their professional work primarily by a desire to either alleviate suffering or improve life quality for the public in some way, and also to advance the practice of whatever their chosen vocation is in whatever ways are within their power.

Best I can tell [and I could be wrong], our primary disagreement[s] concern[s]:

1. our overall assessments of the character of the pharma system. I see its bottom character as antisocial, despite the very, very good people that work within it and the many, many good outcomes lots of people have who encounter it; you regard the system as having an overall prosocial impact, despite the deep antisocial tendencies within it; either that, or you acknowledge it is antisocial in character but want to insist on the benefits the system has for users who have chronic and debilitating illnesses and who have their suffering greatly alleviates. [if this latter characterization is closer to yours, then we don't disagree]. [*****See footnote below!]; and/or

2. The value of trying to characterize a large system. As I said, I could well be wrong, but I am not sure you are as interested in devoting your considerable powers of observation and analysis to the social impact of the pharma system taken as a totality [something I regard as absolutely necessary if one is to have any chance of contributing even in some tiny way to meaningful change], as you appear to be in discussing and analyzing the particulars of one or another aspect of the system. Of course the latter must be done, but there are not just trees here. We have a big, big forest before us, and it can only be see from stepping back for perspective.

None of which means the trees can't tell us a lot of what we need to know. Let me take an example from aerospace engineering rather than medicine to make the point. You of course remember the Challenger disaster of 25+ years ago? You probably also know that there were sufficient engineering safeguards were in place to keep the accident from occurring , and that the engineers charged with making safety assessments actually identified the O-rings before the flight as posing an unacceptably high risk under the expected launch conditions. Citations available upon request, because I don;t want to go searching now.

In other words, the regulatory aspects of the system worked. Engineers, well-meaning and highly competent people all, did their jobs and alerted their superiors. But of course, what happened then is that the engineers were pressured to "take off their engineering hats and put on their manager's hats", or some such similar phrasing. In front of their eyes, the standards for an acceptable launch risk were shifted by their non-engineering superiors, purely because of considerations external to engineering.

In any large institution, the same hierarchy exists, though that doesn't mean the same results always or even most of the time come about. My point, though, I hope, is clear: you will not find a single major institution in this society where the word of the technical experts charged with making safety assessments are the final word on whether or not something unsafe is undertaken. It's not enough to identify a safety risk; if that safety risk has to be judged to be sufficiently harmful to the bottom line, the concern of the safety experts can and often will be overridden. The Challenger case is one example; the Ford Pinto case is another; the Bridgestone tire case is another; Libby, Montana and WR Grace is another. There are trees and trees. In each instance, it was known that people will very likely die or are dying [in the two car case and Libby, for sure;] and a business decision was made to consign them to their deaths. In my view, while these may be extreme cases in terms of outcomes, theyaren't isolated cases of antisocial practice; they are representative of institutional conduct across the board. Decisions are made primarily according to their impact on externalities [money, impact on market share, company image, etc.], and not according to their impact on human lives. It's not that human lives don't enter the equation, it's just that they are a consideration among others [and some of those others are weightier] That is almost by definition antisocial. Luckily, most institutional decision don't cause acute impacts of an antisocial variety more often than they do. Those impacts are typically longer term, but just as antisocial [tobacco industry suppression, for instance].

The prosocial impacts of major institutions are of course widespread, manifold, and easy to find. However, by and large, they are not the sorts of things that a less antisocial institutional apparatus could not also achieve. So I am happy to acknowledge the prosocial aspects of any large system and to discuss the important differences between otherwise antisocial systems, but I don't think most of the prosocial features are exclusive features of any of the current system.

So to sum: individual pharma corporations [and other non-pharma biggies] are antisocial entities, the systems they are a part of have a similarly antisocial character, and focusing attention on the corporations or some part of their behavioral history can be helpful but will not sufficient for putting forward the sort of criticism necessary to contribute to meaningful change to the current system. One must characterize the system as well. Those systems are ones that reward those who conform to their internal logic and economic motivations, and marginalize others who are unwilling to or who resist contorting themselves in order to accommodate those interests.

And ftr: I respect you immensely and would be happy to see you engage what I've said here and elsewhere in any way good-faith way you see fit. I have been and would be the beneficiary.


*****Footnote: it seems you are also a bit fatigued from these sorts of exchanges on RI about Pharma/psychiatry, due to what you perceive to be [and which undoubtedlyis, to some extent] an inability of some of your interlocutors to grasp your true position in its various nuances. I will be so bold as to exclude myself from that group at present, as I think I [mostly] understand where you're coming from well enough [but I could be wrong].

slomo wrote:
If you want to argue that pharma pushes drugs inappropriately and has attempted to create a system where pharmaceuticals are the first course of action in any medical situation, no matter how trivial - I will sign my name to that. If you want to argue that medical research can be corrupt, I will agree. If you want to argue that we as a society would be better off looking at prevention, at creating a socioeconomic system that allows people to lead balanced lives with adequate rest and nutrition free from toxic exposures and occupational dangers, I will completely sign off on that. But I don't think it's appropriate to condemn an entire profession filled with people who sought out in life to alleviate suffering, and who toil under great pressures in order to achieve admittedly mixed results.

This deserves emphasis. I would point out that it is not the profession of medicine that is the main culprit here; it is the institutional or business dimension of medicine that is - or better, it's the successful integration of the profession of medicine with the business dimensions of it that has yielded the current mess. It's those business imperatives for competitive advantage, profit and market share that give a system populated with such talented, well-meaning, exceedingly decent people its overall negative character. Those decent, well-meaning people are not in a position to determine the character of the institution.

[bks]

I thought I might clarify something i wrote above in case it's not clear what I'm getting at. I wrote that:

you will not find a single major institution in this society where the word of the technical experts charged with making safety assessments are the final word on whether or not something unsafe is undertaken. It's not enough to identify a safety risk; if that safety risk has to be judged to be sufficiently harmful to the bottom line, the concern of the safety experts can and often will be overridden. The Challenger case is one example; the Ford Pinto case is another; the Bridgestone tire case is another; Libby, Montana and WR Grace is another. There are trees and trees. In each instance, it was known that people will very likely die or are dying [in the two car case and Libby, for sure;] and a business decision was made to consign them to their deaths. In my view, while these may be extreme cases in terms of outcomes, they aren't isolated cases of antisocial practice; they are representative of institutional conduct across the board.

These extreme cases are representative of a modus operandi within big business I take to be standard: seek to disperse the costs to your customers/clients of company policies [or purposeful company malfeasance] to the extent that it won't be worth it for any one of them to bother you to complain about it. In other words, if you can cheat everybody of our a quarter per month, then cheat them, because that's a lot of money to a company with 25 million customers. Mostly, this M.O. takes the form of legal practices like attaching annoyance-sized fees to basic services and doing whatever can be done within the law to avoid squaring with customers about it.

As anecdotal evidence of the ubiquity of this, ask yourself how many class action notices you've received in the mail within the last, say, five years. I'd say I've received between five and 10. I distinctly remember getting notices that I could join classes against Apple, Citibank [maybe Citigroup] and MBNA. One of them [the Apple one, which I think is still open] might net me $50 bucks or so [something to do with external power sources]; the other proposed settlements were less than $25 bucks, IIRC. Others were for product discounts and other unwanted bullshit.

If you throw into the mix all of the revenue that accrue to companies from customers' forgetting to opt out of things they don't even want or never asked for, or from unwanted automatic renewals of annual contracts, as well as other scammy-type policies, I wouldn't be surprised if it totaled 5% of GDP.

[slomo]

we do agree on all of this, and even much more, I imagine, including at minimum:

*Categorical denunciations of the use of pharmaceuticals or of psychiatry are foolish and prone to significant inaccuracies;

*There are plenty [probably a strong majority] or people working within the pharmaceutical production and delivery system, as well as the larger medical system [and for that matter, EVERY large public-serving institutional system in US society], who are not only highly competent, decent human beings, but who are tireless workers motivated in their professional work primarily by a desire to either alleviate suffering or improve life quality for the public in some way, and also to advance the practice of whatever their chosen vocation is in whatever ways are within their power.

Best I can tell [and I could be wrong], our primary disagreement[s] concern[s]:

1. our overall assessments of the character of the pharma system. I see its bottom character as antisocial, despite the very, very good people that work within it and the many, many good outcomes lots of people have who encounter it; you regard the system as having an overall prosocial impact, despite the deep antisocial tendencies within it; either that, or you acknowledge it is antisocial in character but want to insist on the benefits the system has for users who have chronic and debilitating illnesses and who have their suffering greatly alleviates. [if this latter characterization is closer to yours, then we don't disagree]. [*****See footnote below!]; and/or

2. The value of trying to characterize a large system. As I said, I could well be wrong, but I am not sure you are as interested in devoting your considerable powers of observation and analysis to the social impact of the pharma system taken as a totality [something I regard as absolutely necessary if one is to have any chance of contributing even in some tiny way to meaningful change], as you appear to be in discussing and analyzing the particulars of one or another aspect of the system. Of course the latter must be done, but there are not just trees here. We have a big, big forest before us, and it can only be see from stepping back for perspective.

None of which means the trees can't tell us a lot of what we need to know. Let me take an example from aerospace engineering rather than medicine to make the point. You of course remember the Challenger disaster of 25+ years ago? You probably also know that there were sufficient engineering safeguards were in place to keep the accident from occurring , and that the engineers charged with making safety assessments actually identified the O-rings before the flight as posing an unacceptably high risk under the expected launch conditions. Citations available upon request, because I don;t want to go searching now.

In other words, the regulatory aspects of the system worked. Engineers, well-meaning and highly competent people all, did their jobs and alerted their superiors. But of course, what happened then is that the engineers were pressured to "take off their engineering hats and put on their manager's hats", or some such similar phrasing. In front of their eyes, the standards for an acceptable launch risk were shifted by their non-engineering superiors, purely because of considerations external to engineering.

In any large institution, the same hierarchy exists, though that doesn't mean the same results always or even most of the time come about. My point, though, I hope, is clear: you will not find a single major institution in this society where the word of the technical experts charged with making safety assessments are the final word on whether or not something unsafe is undertaken. It's not enough to identify a safety risk; if that safety risk has to be judged to be sufficiently harmful to the bottom line, the concern of the safety experts can and often will be overridden. The Challenger case is one example; the Ford Pinto case is another; the Bridgestone tire case is another; Libby, Montana and WR Grace is another. There are trees and trees. In each instance, it was known that people will very likely die or are dying [in the two car case and Libby, for sure;] and a business decision was made to consign them to their deaths. In my view, while these may be extreme cases in terms of outcomes, theyaren't isolated cases of antisocial practice; they are representative of institutional conduct across the board. Decisions are made primarily according to their impact on externalities [money, impact on market share, company image, etc.], and not according to their impact on human lives. It's not that human lives don't enter the equation, it's just that they are a consideration among others [and some of those others are weightier] That is almost by definition antisocial. Luckily, most institutional decision don't cause acute impacts of an antisocial variety more often than they do. Those impacts are typically longer term, but just as antisocial [tobacco industry suppression, for instance].

The prosocial impacts of major institutions are of course widespread, manifold, and easy to find. However, by and large, they are not the sorts of things that a less antisocial institutional apparatus could not also achieve. So I am happy to acknowledge the prosocial aspects of any large system and to discuss the important differences between otherwise antisocial systems, but I don't think most of the prosocial features are exclusive features of any of the current system.

So to sum: individual pharma corporations [and other non-pharma biggies] are antisocial entities, the systems they are a part of have a similarly antisocial character, and focusing attention on the corporations or some part of their behavioral history can be helpful but will not sufficient for putting forward the sort of criticism necessary to contribute to meaningful change to the current system. One must characterize the system as well. Those systems are ones that reward those who conform to their internal logic and economic motivations, and marginalize others who are unwilling to or who resist contorting themselves in order to accommodate those interests.

And ftr: I respect you immensely and would be happy to see you engage what I've said here and elsewhere in any way good-faith way you see fit. I have been and would be the beneficiary.


*****Footnote: it seems you are also a bit fatigued from these sorts of exchanges on RI about Pharma/psychiatry, due to what you perceive to be [and which undoubtedlyis, to some extent] an inability of some of your interlocutors to grasp your true position in its various nuances. I will be so bold as to exclude myself from that group at present, as I think I [mostly] understand where you're coming from well enough [but I could be wrong].

slomo wrote:
If you want to argue that pharma pushes drugs inappropriately and has attempted to create a system where pharmaceuticals are the first course of action in any medical situation, no matter how trivial - I will sign my name to that. If you want to argue that medical research can be corrupt, I will agree. If you want to argue that we as a society would be better off looking at prevention, at creating a socioeconomic system that allows people to lead balanced lives with adequate rest and nutrition free from toxic exposures and occupational dangers, I will completely sign off on that. But I don't think it's appropriate to condemn an entire profession filled with people who sought out in life to alleviate suffering, and who toil under great pressures in order to achieve admittedly mixed results.

This deserves emphasis. I would point out that it is not the profession of medicine that is the main culprit here; it is the institutional or business dimension of medicine that is - or better, it's the successful integration of the profession of medicine with the business dimensions of it that has yielded the current mess. It's those business imperatives for competitive advantage, profit and market share that give a system populated with such talented, well-meaning, exceedingly decent people its overall negative character. Those decent, well-meaning people are not in a position to determine the character of the institution.

I don't disagree with much of this, but it does prompt me to suggest that a proper title for this thread is not "Fuck Doctors" but rather "Fuck Insurance and Pharmaceutical Executives" or even "Fuck Executives". But then it would have the same title that about 75% of the other threads on RI deserve.

[bks]

I don't disagree with much of this, but it does prompt me to suggest that a proper title for this thread is not "Fuck Doctors" but rather "Fuck Insurance and Pharmaceutical Executives" or even "Fuck Executives". But then it would have the same title that about 75% of the other threads on RI deserve.

lol, true.

[beeline]

Posted for relevance, hyperlinks at original:

Link

Psychiatry’s Grand Confession

Posted on January 23, 2012
by Jonathan Leo, Ph.D. / Jeffrey Lacasse, Ph.D.

The psychiatry profession has finally come clean and confessed on a national media outlet that there is no evidence to support the Serotonin Theory of Depression. Today, on NPR’s Morning Edition there is a segment about the chemical imbalance theory, and virtually all the psychiatrists who are interviewed acknowledge that the there was never any evidence in support of the idea that low serotonin causes depression. But then, amazingly, they go on to say that it is perfectly fine to tell patients that serotonin imbalance causes depression even though they know this isn’t the case.

Several years ago in PLoS Medicine we wrote a long piece about the serotonin theory and the disconnect between what research psychiatrists say in professional journals and textbooks and what the advertisements say. While the advertisements presented the theory as scientific fact, the scientific sources clearly did not. Given the enormous marketing programs that pushed this theory combined with the media’s lack of skepticism, we were sympathetic to the general public who could hardly be faulted for thinking that theory had some foundation in fact. Following the publication of our piece a reporter contacted us and suggested that we were attacking a well accepted theory. We pointed out to the reporter that we weren’t attacking a sacred cow but that instead we were pointing out the mainstream psychiatry didn’t even accept this theory. We urged the reporter to contact the FDA, NIMH, APA, etc and ask them about the science behind the advertisements. He did, and as expected, an expert from the FDA explained that the theory was really just a metaphor. The problem is that patients who heard their physician explain the serotonin theory thought they were hearing real science. They weren’t told it was a metaphor and hence thought it was a fact. When a doctor talks about high cholesterol, diabetes, or hypothyroidism, they are talking about scientific measurement, not a metaphor. How is a patient with high cholesterol and depression who listens to their doctor’s explanation of their conditions supposed to know when the doctor has moved from science to metaphor?

Several months ago Ronald Pies published an interesting article in Psychiatric Times entitled, “Psychiatry’s New Brain-Mind and the Legend of the Chemical Imbalance.” Pies, just like the experts on NPR, acknowledges that the Chemical Imbalance theory is not true. However, according to Pies, it was the pharmaceutical companies who espoused the theory, and not well-informed, practicing clinicians, because the psychiatry community has known all along that the theory is not true.

But if the Psychiatry Community knew all along that the theory was not true, then why did they not clarify this issue for the general public? Shouldn’t they have pointed out to the general public and patients that what the pharmaceutical companies were saying about psychological stress was not true? Why did the professional societies not publicly set the record straight?

There are many angry comments on the NPR website. These comments are interesting, because apparently many patients who were told that depression is caused by a chemical imbalance never understood that were hearing a metaphor and not science. Since the chemical imbalance theory is often presented as a rationale for taking SSRIs, such patients now understandably feel lied to by their clinicians.

Perhaps the most interesting part about the NPR piece is that the reporter seems to not understand that the idea of telling a falsehood to patients because you think it is good for them is a serious violation of informed consent. Shouldn’t the reporter have asked the obvious questions, such as:

1) Do you feel it is acceptable to present a scientific theory as fact even though you know it is false?
2) Is it okay for psychiatrists to tell patients stories about their conditions that psychiatrists know are false?
3) Is there not an ethical issue when a psychiatrist informs their patient that they have a serotonin imbalance, when the medical textbooks on the shelf clearly say this is a falsified theory?

In general, we are fans of NPR, but hopefully the next news outlet that covers this topic will be more investigative in their approach.

[eyeno]

Posted for relevance, hyperlinks at original:

Link

Psychiatry’s Grand Confession

Posted on January 23, 2012
by Jonathan Leo, Ph.D. / Jeffrey Lacasse, Ph.D.

The psychiatry profession has finally come clean and confessed on a national media outlet that there is no evidence to support the Serotonin Theory of Depression. Today, on NPR’s Morning Edition there is a segment about the chemical imbalance theory, and virtually all the psychiatrists who are interviewed acknowledge that the there was never any evidence in support of the idea that low serotonin causes depression. But then, amazingly, they go on to say that it is perfectly fine to tell patients that serotonin imbalance causes depression even though they know this isn’t the case.

Several years ago in PLoS Medicine we wrote a long piece about the serotonin theory and the disconnect between what research psychiatrists say in professional journals and textbooks and what the advertisements say. While the advertisements presented the theory as scientific fact, the scientific sources clearly did not. Given the enormous marketing programs that pushed this theory combined with the media’s lack of skepticism, we were sympathetic to the general public who could hardly be faulted for thinking that theory had some foundation in fact. Following the publication of our piece a reporter contacted us and suggested that we were attacking a well accepted theory. We pointed out to the reporter that we weren’t attacking a sacred cow but that instead we were pointing out the mainstream psychiatry didn’t even accept this theory. We urged the reporter to contact the FDA, NIMH, APA, etc and ask them about the science behind the advertisements. He did, and as expected, an expert from the FDA explained that the theory was really just a metaphor. The problem is that patients who heard their physician explain the serotonin theory thought they were hearing real science. They weren’t told it was a metaphor and hence thought it was a fact. When a doctor talks about high cholesterol, diabetes, or hypothyroidism, they are talking about scientific measurement, not a metaphor. How is a patient with high cholesterol and depression who listens to their doctor’s explanation of their conditions supposed to know when the doctor has moved from science to metaphor?

Several months ago Ronald Pies published an interesting article in Psychiatric Times entitled, “Psychiatry’s New Brain-Mind and the Legend of the Chemical Imbalance.” Pies, just like the experts on NPR, acknowledges that the Chemical Imbalance theory is not true. However, according to Pies, it was the pharmaceutical companies who espoused the theory, and not well-informed, practicing clinicians, because the psychiatry community has known all along that the theory is not true.

But if the Psychiatry Community knew all along that the theory was not true, then why did they not clarify this issue for the general public? Shouldn’t they have pointed out to the general public and patients that what the pharmaceutical companies were saying about psychological stress was not true? Why did the professional societies not publicly set the record straight?

There are many angry comments on the NPR website. These comments are interesting, because apparently many patients who were told that depression is caused by a chemical imbalance never understood that were hearing a metaphor and not science. Since the chemical imbalance theory is often presented as a rationale for taking SSRIs, such patients now understandably feel lied to by their clinicians.

Perhaps the most interesting part about the NPR piece is that the reporter seems to not understand that the idea of telling a falsehood to patients because you think it is good for them is a serious violation of informed consent. Shouldn’t the reporter have asked the obvious questions, such as:

1) Do you feel it is acceptable to present a scientific theory as fact even though you know it is false?
2) Is it okay for psychiatrists to tell patients stories about their conditions that psychiatrists know are false?
3) Is there not an ethical issue when a psychiatrist informs their patient that they have a serotonin imbalance, when the medical textbooks on the shelf clearly say this is a falsified theory?

In general, we are fans of NPR, but hopefully the next news outlet that covers this topic will be more investigative in their approach.

A world without scurvy...


Beeline thanks for this article. This is a gem. I plan to let a young family member read this.

Background:

A young child grows up with an alcoholic father. From the age of 7 the child lives with his grandparents. Understandably the child has some confusion and feels a little depressed at times about the situation. Regardless the child is well adjusted and normal. The child functions well in school, has many good friends. There are no pronounced behavior problems or bizarre behavior. The grandparents provide a stellar home and are first class guardians and provide the child with more than adequate emotional and material support.

The grandparents, well meaning as they are, suggest to the child that he could take anti-depressants and it might make him "feel better" about the situation. They have seen the commercials on TV, complete with beautiful music in the background as the obvious dangers are listed, spoken by attractive people in white lab coats, and they believe they are seeing the results of hard science.

After the child starts taking anti-depressants he spends most of his time laying in bed if he is not in school or on an occasional jaunt with friends. The child becomes moody and silent. He is no longer the energetic child he once was. The child has no energy and in general does not feel well. It is supposed that the child has simply become more depressed so more anti depressants are administered which only makes the situation worse.

The medicine worsens the problem. After a few decades of studying these types of situations I am convinced that this is no accident, and that this is an intentional design of the industry. The thing that makes it invisible is the fact that people have FAITH in the system and they believe what they are told. As they struggle and get worse they believe the medicine simply isn't working 'well enough' and actually want MORE of the medicine. Well the patient is correct. The medicine is not working.

The child is now 17 years old and lives in the same general pattern.

Life can be stressful. Its part of being alive. I don't think it wise to prescribe a toxin to a person for normal life pressures.

If a person is exhibiting behavior that can be dangerous to himself or others a toxin may be necessary in an effort to mitigate harm. If a person cannot function in society or is in so much mental shambles that they cannot bare life then a toxin may be appropriate. If a person hears voices, and it is driving them over the brink, then a toxin may be necessary. etc...

In this and age a person can go to the doctor and say "I have three kids, my husband and I both work, we barely make ends meet, I'm stressed", and the doctor will often say "here, take this toxin and see how it works." When the drug causes the enzyme levels in the liver to become out of balance, damages kidneys, or a heart problem life will become much more stressful. No problem . There is another toxin that can be prescribed to keep you from feeling the damage, for a while that is.

The human body is like an automobile in many respects. It must operate within certain physical parameters and tolerances to operate effectively. When the red light on the dash of an automobile illuminates it signifies that the car is low on oil. If you take the red bulb out (prescribe a drug) and continue to drive the car it will slowly destroy the car.

"Let food be thy medicine, and medicine be thy food"
Hypocrates

When I was a child the first thing a doctor would ask me was "what have you been eating?" That was back in the days when doctors spent a lot of their med school time in nutrition classes. Doctors get so little training in nutrition these days that they don't understand nutrition. Nutrition is the oil, gasoline, tires, etc...that that a body runs on. Nutrition has been replaced with pharmacy.

Now we have charlatans, doctors, who actually publish rubbish words such as "nutrition is not correlated to health." I actually read that somewhere, and a doctor wrote it. I don't remember where, and I was appalled. He was critical of using vitamins as medicine. Wonder who pays him?

There is a natural remedy nature provides for almost every illness known to the human race. Pharma has made it illegal to state these facts. Most of these remedies are not harmful, but healthy. Vitamin C cures scurvy but it is illegal to say so. SCURVY IS NOT A CONGENITAL GENETIC DEFECT IN MOST CASES, IT IS A LACK OF NUTRITION. Society is awash in scurvy like illness, and it is illegal to say so.

The beginnings of most illness in otherwise healthy people in this day and age is the result of inadequate nutrition, poisons marketed as nutrition, poisons marketed as food, poisons marketed as medicine, or a poisonous environment.

Society is awash in poison, and poison is our medicine.

I think its a travesty. I think some people need a "dose of their own medicine."

[compared2what?]

Posted for relevance, hyperlinks at original:

Link

Psychiatry’s Grand Confession

Beeline thanks for this article. This is a gem.

This part of it is:

Several years ago in PLoS Medicine we wrote a long piece about the serotonin theory and the disconnect between what research psychiatrists say in professional journals and textbooks and what the advertisements say. While the advertisements presented the theory as scientific fact, the scientific sources clearly did not. Given the enormous marketing programs that pushed this theory combined with the media’s lack of skepticism, we were sympathetic to the general public who could hardly be faulted for thinking that theory had some foundation in fact. Following the publication of our piece a reporter contacted us and suggested that we were attacking a well accepted theory. We pointed out to the reporter that we weren’t attacking a sacred cow but that instead we were pointing out the mainstream psychiatry didn’t even accept this theory.

Because ain't that the truth. And my hat's off to the authors for speaking it in a way that could be heard. Personally, I'd pretty given up trying, as I did here:

The psychiatric research community not only regards the proposition that depression is caused by individual imbalances in brain chemistry as much too massively flawed and inadequate a hypothesis to take seriously now, in the present, in 2010, it also regarded it in much the same way in 1980. [/b]

and here:

I think [psychiatric drugs] should be used in a selective, cautious manner. It should be understood that they’re not fixing any chemical imbalances. And honestly, they should be used on a short-term basis. But beyond this, I think we should look at programs that are getting very good results. This is what I love about Keropudas Hospital’s program in Finland. They have 20 years of great results treating newly psychotic patients. They see if patients can get better without the use of meds, and if they can’t, then they try them. It’s a best-use model, not a no-use or anti-med model. It fits with our studies done in the 1970s that found if you use this model, you get better outcomes, and a good number of people get better and go on with their lives.

Just to take a somewhat different tack, though:

The above is a largely sound and unimpeachable statement, with which I largely agree. In fact, there are really only two points with which I'd quibble in it. The first one is:

It should be understood that they’re not fixing any chemical imbalances.


And my problem with that is not that I dispute it, per se. I don't. Because that already is fucking understood. By psychiatry. The chemical imbalance hypothesis is strongly associated in the public mind with depression and with SSRI antidepressants -- and possibly, in a woolly-minded sort of a way generalized from there to apply to all mental disorders that are commonly treated with meds, I don't really know -- but it's not a belief or claim on which psychiatric medicine rests. At all. Even when it comes to the understanding of depression.

And even Wiki-fucking-pedia knows that:

In the past two decades, research has uncovered multiple limitations of the monoamine hypothesis, and its inadequacy has been criticized within the psychiatric community. Intensive investigation has failed to find convincing evidence of a primary dysfunction of a specific monoamine system in patients with major depressive disorders. The antidepressants that do not act through the monoamine system, such as tianeptine and opipramol, have been known for a long time. Experiments with pharmacological agents that cause depletion of monoamines have shown that this depletion does not cause depression in healthy people nor does it worsen the symptoms in depressed patients. Already limited, the monoamine hypothesis has been further oversimplified when presented to the general public.

[compared2what?]

This part of it, on the other hand...

Today, on NPR’s Morning Edition there is a segment about the chemical imbalance theory, and virtually all the psychiatrists who are interviewed acknowledge that the there was never any evidence in support of the idea that low serotonin causes depression. But then, amazingly, they go on to say that it is perfectly fine to tell patients that serotonin imbalance causes depression even though they know this isn’t the case.

...is what you'd have to call a bald-faced lie that has absolutely no basis in reality whatsoever and is of no service or utility to anyone, anywhere, for any purpose at all other than the spreading of false psychiatry-is-evil-and-deceptive propaganda for its own sake.

Because the two (2) experts who speak to that subject:

(a) don't "acknowledge" (or, ftm, "grandly confess") that the chemical-imbalance theory doesn't and never has had much psychiatric or scientific currency. They candidly, accurately and patiently explain it. I mean, it's not like it's news to them. They're used to being ignored; and

(b) THEY DON'T SAY IT'S PERFECTLY FINE TO LIE TO PATIENTS ABOUT ANYTHING

Basically, they say that the upside of two decades of incredibly widespread popular misconceptions about the chemical causes of depression -- which psychiatric science did not encourage and for which it was not responsible -- has been that at least it led to widespread acceptance and recognition of clinical depression as a disorder that should be treated as such. As opposed, say, to a personal flaw that should be condemned and/or concealed. Which is pretty much how it was viewed until quite recently.

Anyway. I should really let them speak for themselves. But please do note the non-existence of anything remotely resembling an endorsement of lying to patients:

So why are so many people still talking about low serotonin causing depression?

Frazer says it's probably because it has had, and continues to have, important cultural uses. For one, he says, by initially framing the problem as a deficiency — something that needed to be returned to normal — patients felt more comfortable taking a drug.

"If there was this biological reason for them being depressed, some deficiency that the drug was correcting," Frazer says, then taking a drug was OK. "They had a chemical imbalance and the drug was correcting that imbalance." In fact, he says, the story enables many people to come out of the closet about being depressed, which he views as a good thing.[/b]

Still, there's no question that the story also has downsides. Describing the problem exclusively in biological terms has convinced many people to take antidepressants when other therapies — like talk therapy — can work just as well.

One critic I talked to said the serotonin story distracted researchers from looking for other causes of depression. But Delgado agrees with Frazer and says the story has some benefits. He points out that years of research have demonstrated that uncertainty itself can be harmful to people — which is why, he says, clear, simple explanations are so very important.

"When you feel that you understand it, a lot of the stress levels dramatically are reduced," he says. "So stress, hormones and a lot of biological factors change."

Unfortunately, the real story is complicated and, in a way, not all that reassuring. Researchers don't really know what causes depression. They're making progress, but they don't know. That's the real story.

Link.

[compared2what?]

Does anyone here think it's perfectly fine for madinamerica.com to lie to its readers?

I don't. It doesn't help anyone. And it sometimes causes a lot of harm. I don't hold madinamerica.com to a different standard than I do any other media outlet in that regard. Because I really don't see why I should.

[compared2what?]

As to this:

http://www.naturalnews.com/022743.html

Chemically-Induced Suicide: 80 Percent of Suicide Victims Took Antidepressant Drugs

First of all:

If you call people who commit suicide victims, you're also calling them criminals. I object to that on the grounds that I have a heart and soul and am capable of feeling compassion.

Second of all:

That doesn't say anything more meaningful about what caused those suicides than it would if it had said:

Firearm-Induced Suicide: More than 50 Percent of Suicide Victims Shoot Themselves

In fact, it's arguably considerably less meaningful. Because there's actually a lot of data indicating that access to firearms increases suicide risk. As does getting drunk. And a number of other things, too. For example: Depression. People who suffer from clinical depression are at a higher risk for suicide than people who don't.

However. There is no evidence that people who suffer from clinical depression and take antidepressants are at a higher risk for suicide than people who suffer from clinical depression and do not take antidepressants. Most clinically depressed people do not commit suicide, whether they take antidepressants or not. Some do.

The commonest and/or major risk factors for suicide are and long have been very well known. To the point that theoretically, it would probably be possible to identify many though not all of the people who were at very high risk for imminent suicide by using a checklist of them. However, that is and probably always will be strictly theoretical. As, imo, it should be, due to there being no way to evaluate people systematically for those factors that wouldn't also be a systematic and unwarranted invasion of privacy.

There is some evidence that some antidepressants cause increased suicidality in adolescents and young adults. That's bad. But at least it's not as bad as it would be if there were any evidence that they caused increased rates of suicide and/or attempted suicide in adolescents, young adults, or anybody else.

And there isn't.

[compared2what?]

Learn more: http://www.naturalnews.com/022743.html#ixzz1kQya2q7T

Originally published February 28 2008
Chemically-Induced Suicide: 80 Percent of Suicide Victims Took Antidepressant Drugs
by Mike Adams, the Health Ranger, NaturalNews Editor

In my opinion, Mike Adams is fully self-discrediting, due to his habit of doing stuff like headlining an 80 percent correlation between suicide and antidepressant use as if it could possibly mean any fucking thing at all by itself, without:

(a) excluding (or even exploring the possibility of) other risk factors; or

(b) making any attempt to explain why the overwhelming majority of people who take drugs that chemically induce suicide don't kill themselves.

The biggest problem with antidepressants by far is that although they're not very effective for most people, they're all most people who seek treatment for depression get. However, the sexual side effects are probably a pretty close second for most men. As they would be for most women, in a better world. Those are serious problems, however boring most people evidently find them to be.

Needless to say, suicide is a far, far more serious problem than either. But....I guess that in a way, I almost wish that antidepressants did have something to do with it. Because very few people really give a fuck about the tragedies of others unless it advances some interest of their own to do so, sadly. So if there was a relationship, it might be possible to capitalize on it for some constructive purpose.

Unfortunately, moot point.

Also, sorry for the digression. As I was saying: Mike Adams, fully self-discrediting, imo. But since the subject has arisen elsewhere on this board, fwiw, here's a nice Co$ video from 1990 in which David Miscavige, John Travolta and others declare their determination to never stop trying to clear the planet of all things that get in the way of Scientology:



And hey! Who's that idealistic crusader whose face fills the screen right at the beginning, @00:26?



Remind you of any Health Rangers you know?


____________________

Quite a resemblance, I'd say. But extraordinary claims do require extraordinary proof. And it's not like Scientology advocates the infiltration of non-Co$ movements and institutions by covert agents, or considers it fair game to lie, cheat, steal and murder in order to achieve its end, or anything like that.

It's honestly not that big of a deal to me why Mike Adams deals in half-truths, lies and alarmist propaganda. That he does it at all is plenty damning, all on its own. So. Just for the record: The part of the above that really matters to me is that I very much wish people found it a little easier to understand that it's actually not crazy, paranoid or monomaniacal to look very, very closely for signs of a hidden agenda in the work of alt-health advocates. For their own good, and also for the common good. Because it's not.

So you guys can make the call, if it's important to you. And please, suit yourselves. I want you to.

[compared2what?]

Just saw this pop up on the radar today. The methods used in this study don't seem like they would reveal accurate results.

Yes they do.

And this part....Unsolicited adverse effects

I feel exactly the same way about the truly astonishing consistency with which anti-vaccine parents never fail to show a chilling lack of concern for (or even awareness of) their children's feelings.

(TAP - My baby son was vaccinated at The Asian Hopsital & Medical Center without permission at birth with GSK's Engerix-B. He suffered two days of drowsiness and loss of appetite. As these were his first two days of life, it was extremely stressful for us the parents.)

TAP - Filipino friends of ours had a premature boy who was treated like a vaccine pin cushion. The parents had n o idea of the risks. The baby boy survived but is now extremely sensitive with asthma, food intolerance, a hernia and is sick all the time. It's not nice to look at his photo.

I mean, to some extent, it's obviously normal for the parents of very young children and/or very demanding children to get stressed out. And when that happens, they obviously have every right in the world to bitch about it, if that's what they feel like doing. To be honest, the first of those two quotes*** probably wouldn't have even caught my eye in another context.

But I swear, on my honor and by everything I hold dear:

I have never ever seen the self-identified parents of vaccine-injured children so much as acknowledge the possibility that any part of their extremely stressful experiences might also have been extremely stressful for their kids. Not one blessed time. It's always about them: Their trials, their suffering, their disappointment, their grief, their loss, and so on and so forth.

IOW: In context, it's always about how chronically, ceaselessly and obsessively unhappy and unsatisfied they are to have the kids they got. Apart from the evils of pharma -- and, of course, the comparative virtues of using one kind of harshly punitive method of draining the irritating imperfections toxins out of their children versus another -- that's pretty much the only thing they ever talk about.

It's very disturbing, albeit also very difficult to convey persuasively without a more representative number of examples. But I'm just too lazy to go out and collect them right now. IIRC, there were quite a few here, though.

A couple of days ago I wrote an article about a prem baby from Belgium (2) who died after receiving a cocktail of vaccines including the rotavirus vaccine. Is it any wonder that this baby lost her life when parents have to rely on studies like this?

That baby was a preemie and a twin who had to be resuscitated at birth, due to health problems that presumably were not vaccine-related. It sounds like she might have gotten bad care from the hospital her parents took her to when she got sick a week after receiving vaccinations -- ie, six days too late for her illness to have been a vaccine-response -- and I condole with them for their loss.
___________________

***That second quote, on the other hand....I mean, "It's not nice to look at his photo"??? Who talks or even thinks about babies that way? It's horrifying. And heartbreaking, too.

People should just order the children they want from a catalog or something if they're not willing or able to love the ones nature produces. (Not really, of course.)