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Hilary's Desk

Non-Evidence based medicine, Part one.

Hilary Butler - Friday, September 03, 2010

A friend of mine, has not long got out of hospital with her fully breastfed baby. She didn’t actually “want” to be in there but the doctor noted a mild fever, and instantly got “fever phobia” and insisted she go to hospital. ESPECIALLY as the baby wasn’t vaccinated. The mother had been quite content with dealing with it herself, but her mother saw the baby and wet her knickers, insisting that the slightest fever needed to be look at by a doctor! To keep her mother happy, (big mistake) she went to the doctor. She didn’t realise that he too, had conditioned fever phobia. Once she got into hospital, things started to unravel.

Without even so much as a swab, H1N1 was pronounced, and then… pneumonia… with the instant rattle of heavy duty antibiotics. The mother folded her arms and said, “I don’t hear or see any signs of pneumonia?”, so the doctor ordered an X-ray, which came back… negative. “Oh, but we think you should do the antibiotics anyway, because it’s H1N1.”

“How do you know it’s H1N1? Where is the evidence for your assertion? Why don’t you test her for it to be sure” the mother intoned.

(Mistake number one: Questioning a diagnosis pulled out of the air on the basis that since H1N1 is “going around” everything must be H1N1.)

“Oh, we can’t do that. The test is expensive, will take a couple of days to come back, and anyway, if we do this right now, she’ll be fine before the results come back!!” the doctor chirped.

Out came the thermometer. “Ah, her temperature is 38.2 degrees. Well give her paracetamol.”

“No you won’t,” said the mother. “Fever is an appropriate response to any infection and shouldn’t be suppressed with drugs.”

( Mistake number two: Telling doctors facts from their own medical literature.)

By this time, the medical profession were getting more than antsy towards this mother. She went to the toilet, leaving her baby alone, and while she was there, the staff administered paracetamol – without her permission.

(Mistake number three: Assuming medical people will leave your baby alone while you back is turned)

She started to mentally lose the plot, but did some deep breathing and decided to cruise, and to say whatever it took to get out of there.

This involved a few lies, and jollying along the staff without compromising her stance. At the same time, when their backs were turned she used other “ways and means” and pretty soon the baby perked up, and the temperature reduced enough for the hospital to say that the bed was needed for someone else.

Once home we sorted it all out and the baby is fine.

This mother couldn’t get out of there fast enough, but you know what?

Her baby will be another unproven H1N1 case for the medical profession to add to it’s statistics which will become part of the “evidence” misinformation.

What worries me, is that not only do we have a medical profession who practice ANYTHING BUT evidence based medicine, but that doctors have also become “thought police”.

There is huge hypocrisy surrounding what the skeptics worshipfully call, “evidence-based medicine”.

For those unsure of what evidence based medicine is: “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”

This of course, is sometimes a chicken and egg situation. 

To get evidence people have to experiment on people.  So sometimes "medical practice" is NOT based on any solid foundation of evidence because there is not yet evidence to refer to.

The medical profession is generally quite happy to experiment on people (witness the long list of off-label and unproven medical treatments used in neonatal intensive care units), so long as those ideas come from them - not the patient.

 

Part Two.

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