Our friend Jay Bhattacharya (ep. 175) is at the center of a major lawsuit claiming that the Biden administration has used the censoring power of big tech companies to get around the first amendment protection of free speech.
Documents released as part of the discovery process and through prior FOIA requests seem to confirm beyond any doubt a direct collusion between the feds and tech giants to muffle, silence, or deplatform critics of lockdowns, mask policies, and vaccine mandates (such as Bhattacharya, co-plaintiff Martin Kulldorff, journalist Alex Berenson, and others). The plaintiffs stand a good chance of winning, and a win would be a huge victory against public health tyranny.Continue reading “Free speech and forced jabs”
With cases of COVID-19 either disappeared or rapidly diminishing from places like Wuhan, Italy, New York, and Sweden, many voices are speculating that herd immunity may have been reached in those areas and that it may be at hand in the remaining parts of the world that are still struggling with the pandemic. Lockdowns should end—or may not have been needed to begin with, they conclude. Adding plausibility to their speculation is the discovery of biological evidence suggesting that prior exposure to other coronaviruses may confer some degree of immunity against SARS-CoV2, an immunity not apparent on the basis of antibody seroprevalence studies.Continue reading “COVID herd immunity: At hand or forever elusive?”
In a matter of less than a decade, “shared decision-making” (SDM) has emerged as the uncontested principle that must inform doctor-patient relationships everywhere. Consistently lauded by ethicists and medical academics alike, it has attracted the attention of the government which is now threatening to penalize doctors and patients who do not participate in SDM prior to providing certain treatments, even if the legal process of informed consent has been fulfilled—and even if the treatment is widely considered to be clinically justified.
For example, in a recent issue of JAMA, an editorial approvingly reports that the Center for Medicare and Medicaid Services will soon refuse to pay physicians and hospitals for the implantation of cardioverter-defibrillators unless the decision to implant these life-saving devices was “shared” with the patient. Although the announcement is short on details regarding the formal process by which SDM must be documented to have occurred, the new policy certainly testifies to the unquestioned status SDM has rapidly acquired as a general principle of medical ethics.
Where does the idea of shared decision-making come from and how did it suddenly emerge to represent the highest of bedside virtues? I will present historical development of that concept in this post and examine its highly problematic aspects in more detail in subsequent articles.Continue reading “The case against shared-decision making”
We just did a fantastic interview with the legendary G. Keith Smith, MD, co-founder of the Surgery Center of Oklahoma.
Early in the interview, Dr. Smith speaks of the motivation that pushed him and his partner, Dr. Steven Lantier to divest themselves from the government-insurance-hospital system back in the late 1990s: They wanted to stop enabling what Smith identified as “financial serial killers,” so-called non-profit institutions that end up charging astronomical prices for healthcare yet have no qualms about bankrupting defenseless patients who are unable to pay those prices.Continue reading “How to rid medicine of its cronyism”
How do we know that a treatment is bunk and doesn’t even need to be tested to be disproved?
A recent blog post by obesity expert Jason Fung ads fuel to the fire in the debate that opposes the standard-bearers of “science-based medicine” to those whom they view as practicing or promoting “pseudoscience.”
Fung attacked the perennial debunkers and his blog post prompted an immediate riposte by Dr. David Gorski.
Anish and I tried to sort through the controversy.
One of the most tiresome clichés in health care policy is the one that asserts that drug companies can mesmerize patients and doctors into using ineffective pharmaceuticals simply by way of an advertising campaign.
That claim was just made in the editorial pages of JAMA Internal Medicine and promptly spread via social media. The editorial purports that Allergan has managed to make vast sums of money in sales of Restasis, a dry eye treatment, even though the medication is demonstrably ineffective.
Anish and I examine the claim and find it seriously wanting. Here are the time stamps and the video (total watch time ~ 20 minutes):
A tweet catches Michel’s attention 0’30”
Anish summarizes the paper 1’30”
How do we know the drug “doesn’t work?” 4’20”
Anish presents his own market research…surprise, surprise, it’s Fake News! 9’05”
The “pharmascolds” are ideologues with no credibility 13’20”
I was interviewed by Tom Woods on his great podcast. We talked about the Alfie Evans case and discussed in depth the question of “best interests” of the child, and the appalling reasoning by which the UK medical authorities and the court decided that he was better off dead. I think you’ll find the episode worth listening to.
In reading about the case I discovered that the UK judge presiding over the case was greatly offended by a comment made by Dr. Nikolaus Haas, the German physician who—along with the doctors from the Vatican’s Bambino Gesu Hospital—had offered to transport the baby out of the UK and provide the care that the parents requested, namely, placement of a tracheostomy and feeding tube so he could be cared for at home.
In his report to the court, Dr. Haas said the following, which the judge found “inflammatory and inappropriate:”
Because of our history in Germany, we’ve learned that there are some things you just don’t do with severely handicapped children. A society must be prepared to look after these severely handicapped children and not decide that life support has to be withdrawn against the will of the parents if there is uncertainty of the feelings of the child, as in this case.
What happens when you’re a healthcare policy wonk and the pilot study for your pet program has failed miserably? You declare “Success!” in the editorial pages of the New England Journal of Medicine and demand that the program become nationwide and mandatory.
I kid you not. This is exactly what happens.
Thankfully, Anish Koka is vigilant and explains the blatant obfuscations and manipulations that the central planners engage in to have their way.
In our latest video, we reveal the machinations, take the culprits to task, and discuss pertinent questions regarding health care organization: Does “capitation” reduce costs? Do employed physicians necessarily utilize fewer resources? What happens when a HMO and a traditional fee-for-service health system operate side-by-side in a community?
In his judgment about Alfie Evans rendered February 20, 2018, Justice Hayden of the UK’s Royal Courts of London writes:
Crucial to the decision I am being asked to make is the need to ascertain, as accurately as it can be, the present level of Alfie’s awareness. Accordingly, I considered that an up-to-date MRI scan was a significant component in the broad sweep of evidence that was likely to inform this assessment.
Nowadays, it may seem obvious that an MRI should inform someone about another person’s level of consciousness because it is widely assumed that if consciousness is present, it must somehow be present “in the brain.”
I don’t have time now to discuss in detail why that view is not quite correct (you can sign up for my Philosophy of Nature and Man course if you have the urge to know!), but I am reminded of 2 amusing items.
Michael Cannon, director of health care policy at the Cato Institute, has just published a piece where he criticizes conservatives for being “all wrong” about the Alfie Evans case which, according to him “had almost nothing to do with socialized medicine.”
As hostile as libertarians are to government, even we believe government can legitimately order the withdrawal of life support, and prohibit parents from moving a child to obtain further treatment, when that treatment would fruitlessly prolong a child’s suffering – i.e., when further treatment would be akin to torture.
But the court’s decision to prevent Alfie’s parents from obtaining the free care offered by the Vatican had nothing to do with limiting the child’s suffering.
As Cannon himself concedes, neither the court nor the doctors had any way of knowing if the child was suffering or not. In fact, they were in agreement that the child was in a coma, without any awareness of the external environment (and certainly not subject to a treatment “akin to torture”).
What the court actually argued is that dying was in the child’s “best interests”—even absent pain and suffering. That specific stipulation comes from recent guidelines by the Royal College of Paediatrics (RCP), which essentially argue that state-employed doctors can, by fiat, assert that a child’s quality of life is poor enough that he or she should die—and must die.
Cannon’s thoughts on Alfie’s case are still “tentative,” he tells us, but not tentative enough to take issue—as a libertarian—with a health care system where a government can forcibly prevent loving parents from providing life sustaining treatment for a sick baby at no cost to the taxpayer. If the RCP’s guidelines are a perversion of medical ethics, Cannon’s position has got to be a perversion of libertarianism.
Meanwhile, if you would like a sane perspective on the insanity of the Alfie case, below is my latest video with Dr. Anish Koka, in which we discuss this at length.
