Leisure, Lifestyle & Wellness
Rationalising Drug-pushing
What does rationality in medical intervention mean?
 
“The illogical man is what advertising is after. This is why advertising is so anti-rational; this is why it aims at uprooting not only the rationality of man but his common sense.” — Henryk Skolimowski
 
The mad rush for irrational medical interventions— both medicine and surgery—seems to be at its peak now. Demands are growing all over the world for rationality in medical interventions, not the least in the UK and USA. Going through the history of the word rational, I found that, way back in 1803, the meaning was: “to explain, to make reasonable;” in the psychological sense of “to give an explanation that conceals true motives.” Makes sense. This article draws heavily from one of my earlier articles in the British Medical Journal (BMJ).
 
There is a good movie, Big Bucks, Big Pharma, on this topic which is worth watching. I shall give the readers a glimpse of the theme of the movie here. Big Bucks, Big Pharma, pulls back the curtain on the multi-billion dollar pharmaceutical industry to expose the insidious ways that illness is used, manipulated and, in some instances, created, for capital gain. Focusing on the industry’s marketing practices, media scholars and health professionals help viewers understand the ways in which direct-to-consumer (DTC) pharmaceutical advertising glamourises and normalises the use of prescription medication and works in tandem with promotion to doctors. Combined, these industry practices shape how patients and doctors understand and relate to disease and treatment. Ultimately, Big Bucks, Big Pharma challenges us to ask important questions about the consequences of relying on a for-profit industry for our health and well-being.
There is an apt comment on this movie by an American movie critic: “In my opinion this is the best made film regarding the pervasiveness of drug companies in our everyday lives. The film starts with narration by the famed journalist Amy Goodman but lets the interviews themselves narrate the film later on. Though this film doesn’t address the subject directly, if you want to know why the United States doesn’t provide universal healthcare, I think that you should watch this movie. Why should we have free or inexpensive healthcare if the current system is so profitable?”
 
I think, our present therapeutics and its attendant pseudo-science would be correctly described by this meaning of the word—rational. The industry that tries the marketing strategy of rationalising drug-pushing and disease-mongering by concealing their true motive—to make the highest profit for themselves—can never be altruistic and listen to your sane advice. The story of insulin pens was one such effort. Now, many other drugs have come with pens! I am reminded of what Bernard Mandeville, the guru of laissez faire, when he wrote: “In the corporate economy profit is the sole motive irrespective of consequences.” How very true! Our drug cartels have taken his advice to their heart.
 
Taking the advice for rationality in the New Year, I hope some one will come up with audits like the one which showed aspirin in its true colour for all the newly introduced drugs. Remember we have had digoxin for nearly 350 years since William Withering’s time. 
 
Even now, the DIG (digoxin investigation group) recently failed to find out why digoxin is prescribed for heart failure patients in sinus rhythm. Why is the rate of death from adverse drug reaction (ADR) going up exponentially with so-called scientific advances in modern medicine? Was not Ruth Richardson right in saying that modern medicine, which has become a corporate monstrosity, would have cut many James Wakelys in the knees? 
 
James Wakely, a young doctor in London and a member of the House of Commons, thought in early 19th century that medical profession, at that time. had become a bad abscess on the body of society. He wanted to cure it by taking out the pus using a surgical lancet. He started the now famous medical journal, The Lancet, for that purpose in 1823AD. He had assessed the profession at that time to be a bunch of “incompetent, corrupt and nepotistic of crooks.” Poor man, even after nearly 200 years, the abscess, that modern medicine was then, is only growing bigger by the day, despite The Lancet!
 
Even the president of NICE (National Institute of Health and Care Excellence), Sir Michael Rawlins, in his Harveian Oration at the Royal College, had this to say in 2008: “Randomised controlled trials (RCTs), long regarded as the ‘gold standard’ of evidence, have been put on an undeserved pedestal.” Sir Michael outlines their limitations in several key areas, arguing that a diversity of approaches should be used to analyse the whole of the evidence base. Let me remind the readers that the ‘first pass effect’ that we, medical students all over, memorised for the pharmacology examination, must have given us the warning that all (I mean all) reductionist chemical molecules, ranging from aspirin to rosiglitazone, are alien to the human system. The body tries to get rid of them. This has now been demonstrated by Douglas C Wallace, using his software MITCHIP, to be true! 
 
We will have the same story every year to welcome the New Year, if we do not learn from our mistakes. We need another Bernard Shaw to write a drama on patients’ dilemma today.
When you watch the movie cited above, you will come to know how people like you are brainwashed to ask your doctor for those wonder drugs advertised daily as panacea for this or that disease. Often, it is likely that you might even imagine a disease (disease-mongering by the industry) to have the treatment ‘very early’. 
 
How does the common man, even the literate one, survive in this polluted atmosphere where the industry and the profession seem to be in cahoots with each other for personal gain? To add to this, a new industry has grown around this rationality, corporate hospital industry, especially in developing countries like India, where even today more than 400 million people get less than one clean nutritious meal a day. Some 47 million children suffer from nutritional immune deficiency syndrome (NIDS) and die by the thousands daily! Let us have a heart.
 
“Appeals to rationality are mostly bluff. There is no good theory of what it is or of how to recognize it.” —  Mellor DH 

 

(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)

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‘Class’ suit auction: Rs4.31 crore for Narendra Modi's monogrammed suit
A diamond trader from Surat won Narendra Modi’s pinstriped monogrammed suit for a whopping Rs4.31 crore after three days of bidding 
 
A Surat-based diamond trader Friday won the bid of Prime Minister Narendra Modi’s pinstriped monogrammed for Rs4.31 crore.
 
Earlier, the scramble to possess the controversial suit of Prime Minister Modi grew with Surat-based diamond trader Mukesh Patel making a staggering bid of Rs2.31 crore on the last day of the auction. Patel had earlier offered Rs2 crore, but later raised the bid through a written offer of Rs2.31 crore to Rs4.31 crore.
 
“I had lost courage as the bidding amount kept on increasing. Then I talked to my business partner who showed readiness to make the bid of Rs2.31 crore,” said Patel, who came to the auction venue with his business partner Sanjay Movaliya.
 
“We will go ahead as per our capacity. We wish to contribute to the ‘Clean Ganga’ mission and that is the reason we have increased our bid,” he said.
 
The auction at the Science Convention Centre closed at 5pm, after which the articles will be handed over to the highest bidder.
 
Prior to Patel, a Haryana-based company’s MD offered Rs2.09 crore for the suit.
 
There have been 11 bids so far on Friday, with four offers of more than Rs2 crore to claim the suit that Modi wore at his meetings with US President Barack Obama during his India visit last month.
 
Prior to Mukesh Patel, Haryana-based LPS Bossard’s MD Rajesh Jain, through his representative Himanshu Parmar, made an offer of Rs2.09 crore for the suit. This was the second bid by Jain, who had earlier offered to buy the suit for Rs1.85 crore.
 
“The good cause of funds going to ‘Clean Ganga’ mission is the motivational factor for the bid. Besides, it is the responsibility of the industries to make bid for a good cause,” Parmar said.
 
Earlier, another Surat-based diamond trader Hitesh Patel had offered Rs2.08 crore, which was his third bid of the day after Rs1.61 crore and Rs1.75 crore.
 
“I have made the bid of Rs2.08 crore for the Modi suit. I don’t know how further I will go, but as this fund will be utilised to clean river Ganga, whatever I give would be less,” Hitesh said.
 
Earlier in the day, businessmen Lavji Badshah and Jayanti Aklara made a joint offer of Rs1.81 crore to purchase the monogrammed suit.
 
Mumbai-based businessman Vipul Shah, managing director of Asian Star, made a written bid of Rs2.05 crore, while prior to him Mukesh Patel offered Rs2 crore for the suit.
 
The other six bids made on the last day of the auction were less than Rs2 crore.
 
On the second day of auction Thursday, the highest bid was Rs1.48 crore for the suit.
 
The bidding for the suit had started with Rs11 lakh on the first day of auction.
 
The suit that kicked up a political storm is being auctioned along with 455 items that Modi had received as gifts during his nearly nine-month long tenure, to generate funds for the Prime Minister’s ambitious ‘Clean Ganga Mission’.
 
Modi was photographed wearing the suit during his summit talks with Obama in Hyderabad House in Delhi on 25th January and at a joint media appearance that followed the meeting.
 
On closer inspection, photographs showed that the stripes were actually a monogram – Narendra Damodardas Modi – and embroidered on the fabric vertically.
 
The suit triggered a debate and Modi was slammed by his political opponents – especially the Congress and the Aam Aadmi Party (AAP) for wearing an expensive suit that some reports claimed cost nearly Rs10 lakh.
 
Amid the media hype surrounding the auction, Congress workers had Thursday protested outside the auction venue, calling the event an act of “self-publicity” by Modi. 

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Two energy consultants held in oil ministry information leak case
The rooms that the accused had allegedly accessed in the middle of the night to steal official documents included rooms of joint secretary for refineries and joint secretary for exploration, besides rooms of some directors in the oil ministry
 
Investigation into the alleged leaking of classified documents from the Petroleum Ministry picked up pace Friday with the arrest of two more persons by Delhi Police. This takes the number of those held in the sensational case to seven.
 
“We have arrested Prayas Jain and Shantanu Saikia in this connection. Both of them are energy consultants who received stolen documents,” said a senior police official.
 
Saikia is a former journalist who runs a web portal on petroleum issues and has his office in Defence Colony in South Delhi. Jain runs his consultancy firm in Patel Nagar in Central Delhi.
 
Cracking down on a suspected case of corporate espionage, Delhi police on Thursday had arrested two officials from the Oil Ministry and three other middlemen in connection with alleged leaking of classified government documents to energy companies for money.
 
The Crime Branch sleuths arrested Asharam (58) and Ishwar Singh (56), who were employed as multi-tasking staff in the ministry, along with three of their alleged accomplices.
 
The other arrested persons include Lalta Prasad and Rakesh Kumar, brother and son of Asharam, who were previously employed as multi-tasking staff at Shastri Bhawan.
 
In the afternoon Friday, police took all the five arrested to the Petroleum Ministry. They were taken to the rooms of senior officials which they had allegedly accessed using duplicate keys.
 
The rooms, that they had allegedly accessed in the middle of the night to steal official documents, included rooms of joint secretary (Refineries) and joint secretary (Exploration), besides rooms of some directors.
 
The bunch of keys allegedly found in their possession was used to open the rooms of top ministry officials they are suspected to have accessed, police sources said.
 
The rooms they had allegedly accessed included that of Special Secretary, two joint secretaries and some directors dealing with sensitive issues like exploration policy, petroleum pricing and gas pricing.
 

 

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