Wednesday, 27 March 2013

Book review: Meaning, Medicine and the Placebo Effect

Title: Meaning, Medicine and the Placebo Effect (2002)
Author: Daniel Moerman
Publisher: Cambridge University Press

In this book, an anthropologist offers an outsider’s view of medicine. The book is not restricted to an examination of the placebo effect (in fact, the author suggests abandoning the term, instead using “meaning response”); it asks readers to see all of medicine (and indeed biology) in its social and cultural context. The author shows that much of what we “know” isn’t necessarily true (or more confusingly, that it might be true in certain contexts). In that vein, he criticises doctors for dressing in science (empirical evidence), but practicing experiential evidence, and therefore not being able to see that what they “know” (based on tradition and their own experience) might not be true (despite being able to construct biological mechanisms to explain the perceived effect).

Tuesday, 19 March 2013

Lessons from history #6: The Vioxx saga

The Vioxx saga contains everything: conflicts of interest, big pharma influence, dodgy government regulators, data fabrication, and a body count. But there is more to the story: it is an example of a common logical fallacy whereby, when faced with a study that shows treatment A to be better than treatment B, we assume that treatment A is providing a benefit, and not that treatment B is harmful. Both assumptions may be equally valid, but we tend to choose the former. Had we not done so in this case, Vioxx might not have harmed so many people.

Sunday, 10 March 2013

Book review: Rethinking Aging: Growing Old and Living Well in an Overtreated Society

Title: Rethinking Aging: Growing Old and Living Well in an Overtreated Society (2011)
Author: Nortin M Hadler
Publisher: University of North Carolina Press, Chapel Hill

In his latest offering, Dr Hadler rehashes and updates many of his familiar arguments (breast and prostate screening, cardiac stents, osteoporosis, antidepressants, back surgery), this time applying them to the elderly. He adds material specifically about growing frail and dying, and as usual, he provides considerate, accurate, useful and often counter-intuitive information for the would-be health care consumer.