Category: Medical Ethics
The NCCAM Seeks Comments for its “Strategic Plan: 2010.” Part I
The National Center for Complementary and Alternative Medicine (NCCAM) has posted three essays about its latest “strategic planning process,” and has invited “stakeholders” to make comments. I have previously made my own opinions clear,* as have fellow bloggers Gorski, Novella, Lipson, and Sampson: the best strategic plan for the NCCAM would be to extinguish itself. Since politics makes that plan unlikely, there...
“Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part II: Loose Ends)
Last week I discussed the dismal results of the “Gonzalez Trial” for cancer of the pancreas,* as reported in an article recently posted on the website of the Journal of Clinical Oncology. I promised that this week I’d discuss “troubling information, both stated and unstated [in the report],” and also some ethical issues. More has come to light in the past few...
“Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part I: Results)
Review One of the more bizarre and unpleasant “CAM” claims, but one taken very seriously at the NIH, at Columbia University, and on Capitol Hill, is the cancer “detoxification” regimen advocated by Dr. Nicholas Gonzalez: Patients receive pancreatic enzymes orally every 4 hours and at meals daily on days 1-16, followed by 5 days of rest. Patients receive magnesium citrate and Papaya...
The price of cancer quackery
I don’t have much to add to this one, as it’s a tragic tale. Shadowfax, a blogging ER doc, relates to us what happens when cancer patients rely on quackery like the Gerson protocol instead of scientific medicine: This was a young woman, barely out of her teens, who presented with a tumor in her distal femur, by the knee. This was...
Sectarian Insertions
I will write occasional posts instead of being on a regular schedule. The reasons: There are more contributors than positions. Newer people to the field have more ambition and belly fire. I have a number of projects and papers to finish in increasingly limited time and decreasing efficiency. So have at it. Meanwhile, some non-random thoughts. I am as concerned with social...
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September 3, 2009
The perils and pitfalls of doing a “vaccinated versus unvaccinated” study
The anti-vaccine movement is nothing if not plastic. It “evolves” very rapidly in response to selective pressures applied to it in the form of science refuting its key beliefs. For instance, when multiple studies looking at the MMR vaccine and autism failed to confirm the myth that the MMR causes autism or “autistic enterocolitis,” most recently late last year, it was not...
The Microbial Metagenome
First some background. I was first directed to the Marshall protocol by a reader who wondered about the information the found on the web. So I went to the web and looked at the available information, much as any patient would, and discussed what I found there. I have subsequently been lead to believe that none of the information on the website...
Science-Based Medicine Meets Medical Ethics
There are four main principles in medical ethics: Autonomy Beneficence Non-maleficence Justice Autonomy means the patient has the right to consent to treatment or to reject it. Autonomy has to be balanced against the good of society. What if a patient’s rejection of treatment or quarantine allows an epidemic to spread? Beneficence means we should do what is best for the patient....
Incorporating Placebos into Mainstream Medicine
Alternative medicine by definition is medicine that has not been shown to work any better than placebo. Patients think they are helped by alternative medicine. Placebos, by definition, do “please” patients. We would all like to please our patients, but we don’t want to lie to them. Is there a compromise? Is there a way we can ethically elicit the same placebo...
NIH Awards $30 Million Research Dollars To Convicted Felons: Cliff’s Notes Version
In case you’re coming late to this discussion (or have ADD), I’ve summarized Dr. Kimball Atwood’s terrific analysis of the ongoing clinical trial (TACT trial) in which convicted felons were awarded $30 million by the NIH. *** In one of the most unethical clinical trial debacles of our time, the NIH approved a research study (called the TACT Trial – Trial to...