Rapid Responses to:

EDITORIALS: Keith J Petrie and Simon Wessely Modern worries, new technology, and medicine BMJ 2002; 324: 690-691 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Accountability, gentlemen! Accountability!

Gurli Bagnall   (23 March 2002)

Accountability, gentlemen! Accountability! 23 March 2002
Gurli Bagnall, Patients' Rights Campaigner Send response to journal: Re: Accountability, gentlemen! Accountability!	Petrie and Wessely are right in two respects. Extraordinary improvements in public health have occurred - at least in the early part of last century. The improvement was mainly due to a better standard of living - food, housing, hygiene – rather than improved medical expertise, attested to by the fact that we still do not have cures for a number of diseases. It is also true that in the last four plus decades, we have progressively experienced more symptoms and “feel worse than our ancestors did”. However, the authors offered no proof to back their opinion that this is psychogenic illness (hysteria), and ignore the indisputable fact that the symptoms have coincided with the increasing production of pharmaceuticals and other chemicals. While it might be politically expedient to sweep that under the carpet, when faced with a patient who is thus affected, a doctor is ethically bound to take the facts into consideration. The authors favoured us with examples of our “gullibility” - medical scares transmitted by the internet, such as antiperspirants causing breast cancer, and the spread of necrotising fasciitis by bananas. On the other hand, we have been told by the experts, that contraceptive pills are safe, only to find that they cause blood clots; we were exhorted to stay out of the sun to avoid melanomas, but now we are told that staying out of the sun causes other cancers due to lack of vitamin D; if our cholesterol levels were high, we were told to give up eggs only to find some years later, that eggs are perfectly safe. The list goes on and on. Which is worse - patient “gullibility” or experts feeding the public misinformation? Throughout the ages, basic education, or none at all, ensured a level of ignorance amongst the poor which afforded power to others who abused it, and who even justified the act of oppression by quoting the scriptures. Petrie and Wessely mourn their loss of power and the ignorance that once gave it to them. “A recent US study of hospital outpatients had found that 25% of patients had used the web for medical information in the past year and that 60% planned to do so in the next year” they said. Clearly they are outraged at the presumption of the proletariat, but before putting pen to paper, they should have asked the question: “Why do people no longer trust us?” Instead, they skirted around it. “Well publicised crises, most obviously bovine spongiform encephalopathy and foot and mouth disease, have severely dented confidence....” It is interesting to note that the only confidence-denting medication mentioned, is thalidomide. The benzodiazepines have destroyed millions of lives internationally. Why was this group of drugs not mentioned? There is a vast difference between the authors’ implied state of paranoia, and the reality - i.e. he who does not learn from experience, is a fool. Both authors, know the iatrogenic statistics, so one would think they also know the magic word for turning the tide - accountability. No amount of self-serving articles will change that. A sick person wants nothing more than to be able to leave the management of his or her illness to a competent physician, but where there are questions about that competency, then in the interests of survival, the patient has no option but to take matters into his or her own hands. Gurli Bagnall, Patients' Rights Campaigner, Otago New Zealand