Editorial: One of my regular readers dropped me an email after the last post saying that the Montelukast Withdrawal Syndrome post on RxISK was wonderful but Something Happened on the same day was incomprehensible. The title was a give-away. Something Happened but it doesn’t seem to me that anyone knows quite what. Here’s another take on Something Happened and a currently blank sheet of paper might have yet another take next week. Another angle on this are the RxISK posts on Transgender Meds – where something is happening – but what?
A moral crisis may have been inevitable with the creation of the printing press. The crisis took shape when Martin Luther nailed his theses to a Cathedral door in 1517. It could not be avoided after 1649 when Charles I of England was decapitated.
The word hierarchy derives from hieros (the holy) – and refers to the primacy of the moral or the sacred. An absolute sovereign held a moral rather than just a political order in place. The monarch was responsible for justice and benevolence within the monarchy. Justice involved decisions based on wisdom. The requirements of benevolence meant that we were all, from the monarch down, responsible for the welfare of others in addition to ourselves, and all were answerable to God.
Charles had his head chopped off for moral reasons – for straying too far from godly living. After his decapitation the moral order was going to have be held in place in a different way.
Even though it was a drive to be more religious and moral that led to this outcome, somehow religion alone didn’t seem capable of filling the void. The world that needed governing by then had become more complex than any previous monarchy or theocracy had faced.
The Individual
Supported by the role of techniques in triggering science, from Descartes in 1649, through Locke and Kant, Enlightenment philosophers claimed they could fill the void. They created the ideal of an autonomous subject reasoning in a detached way about us and our place in the universe. The flourishing of science made this option seem compelling to many. A new individual was born who at least in one part of their lives didn’t just take the word of the Ruler as Gospel or the Gospel as Rule.
In this new dispensation, the requirements of justice and benevolence led to constitutional government, the idea of universal human rights, an independent judiciary, the development of contracts and later welfare systems.
These are achievements to take pride in, but the changing times triggered a “Romantic” reaction. The romantics held there were important values and forces the philosophers and scientists and liberals were missing. The decapitation of Louis XVI in 1793 and the French revolution made liberal civilisation seem like a thin crust beneath which molten passions swirled.
The detached approach was taking us into a world of instruments and procedures. For the romantics there was more to life than this. We needed wisdom rather than just detachment and would need to supplement philosophy or science with something else to believe in. Some turned to Nature, others to Art, some to the People and others to other forces rolling through history that religion had harnessed but disinterested rationality seemed less capable of managing.
Harnessing was something monarchs and religion had done. Managing is what technocrats aim at.
All techniques and procedures embody an intelligible element, an algorithm, just as everything that functions from bacteria and viruses to thermostats and computers do. The question is whether there is more to humanity than a complex collection of intelligible elements. In caricature form, science and technocracy says there is nothing more.
On a political level, Marxism and psychoanalysis were in this sense romantic – religions reborn in a scientific age. Both had technical aspects that gave them the appearance of science, or a footing within the sciences, but at bottom the materialism of dialectical materialism and the libido of psychoanalysis were mystical concepts rather real-world entities with a precise meaning.
Modernism
The twentieth century brought a new twist. The modernism of science and its turn to techniques and procedures led to bureaucracy on the one hand and a new modern individual on the other – the displaced individual. She has become a stranger in a strange land rather than a child of the universe.
This showed up in modern art, where from T.S. Eliot through to Borges and Calvino rather than stories we had stories told through story-tellers. In painting from the impressionists onward we had art that showed its artifice. In architecture, we ended up with buildings that showed their plumbing on the outside.
Unsurprisingly the same happened to science – in this case it was termed post-modernism. The scientific process and scientific events and their protagonists were all now situated in a story. Discoveries were no longer pure and simple but rather constructs held in place by methods. The objections of scientists to being situated within not just a story but a story-telling is in part what led to the Science Wars. The other part was the clumsiness of the social scientists.
It should have been possible to seduce the scientists in the way Christians had been seduced. While many Christians were distraught about the nineteenth century transformation of the Bible into a set of stories (Ta Biblia) rather than one master narrative (Biblos), for many others the investigation of the Bible produced an even more interesting set of stories. Our new understanding allowed us to celebrate the emergence of a much more person-centered world than had been found in previous hierarchies – whatever about the ultimate meaning of that world ushered in by the events the stories described.
The rhetoric, if not the DNA of science, suggests that faced with uncertainties scientists are less likely to react fundamentalistically than some religious. So, on the face of it, bringing them around should have been possible. But maybe even with the perfect art we would still have had a problem.
Something Else This Way Comes
Perhaps from say 1980 onwards, there was something else at play. This is what Roy Porter’s review of Listening to Prozac says to me – there must have been something else going on.
All through the 1990s and beyond, the surprise for me was that social scientists were being bowled over by what seemed, in the case of things like Prozac, huckster’s trinkets. They seemed as happy to hand over Manhattan for a bunch of the new trinkets as the Indians were when the Dutch turned up just before 1649.
What else might have been going on?
One option is science. The pace of advance picked up relentlessly from the 1940s. The atom bomb turned the world upside down. We crossed a threshold and now we for the first time posed a greater threat to Nature than Nature posed to us.
This was at least as obvious in medicine, as in any other branch of life, which from the discovery of DNA to the Human Genome Project seemed to be handing us the means to remake ourselves. We could make the New Man, and be better-than-well.
But could science, even as epic as this, be the source of our problems? Science is visionary. It might destroy an old order, but it also reaches for a new one. While it doesn’t necessarily make individual scientists any better human beings, it doesn’t make them worse either and pooling our fallibilities as science does has unquestionably advanced our situation in many respects while causing other problems.
Another option also stemming from the Enlightenment lies in the procedures we began to put in place rather than the instruments we developed.
From 1800 or so, it became clear that procedures would be applied to government. This was a move that came from the people – from the bottom of up. We had weights and measures so that even a King couldn’t arbitrarily decide what a certain amount of produce weighed and was therefore worth – we couldn’t be as easily cheated by power.
The production of goods, including medicines began to be standardised and regulated. Professionals like doctors, and others, began to be accredited.
Where England developed the idea of constitutional government and now thinks of itself as the cradle of democracy, the application of procedures to government probably flourished most vigorously in Prussia and underpinned the unification of 39 different States with different religions into Germany.
The ultimate expression of this lay in the Holocaust which became the event it was because of the marriage of terrible intention with efficient bureaucracy. The bureaucracy also played a part in its undoing, when without the appropriate authorisation the camp apparatus refused to release the trains, used to transport “workers” to the camps, to take German troops to the Eastern front.
The first hints that a bureaucracy might be spiritually damaging perhaps lies in Dostoyevsky but the most devastating portraits of its soullessness came from Kafka in the 1920s. Their warnings had no effect. By the 1930s, totalitarian bureaucracy had emerged as a new force in the world.
It’s important to distinguish the primacy of procedures from the people. The assumption in the West after the War was the Nazis were perverted, deviant, psychopathic, evil and we needed checks and balances in place to keep Germans on the rails. But any of the psychological testing done on Germans, even concentration camp guards, showed them to be if anything better balanced and more normal than the American soldiers liberating the camps. And the bureaucracy that had led to the Holocaust was a triumph of checks and balances that now seemed needed to prevent it happening again.
The early successes of Germany in the War led most allied countries, particularly America to figure that the future lay with management – aka bureaucracy or totalitarianism. Far from learning the lessons of the War, troops returning home got a free pass into universities places to learn management science.
This in part underpinned the upheaval of the 1960s where students and others protested against the encroaching of a new apparatus. There were protests against science that seemed to be undermining our understanding of ourselves, and a turn to “religion” in the form of cults, but the deeper protests were against the apparatus and conformity.
On the surface Marx and Freud were pitted against liberalism and science – this was a replay of Romance against Science.
But beneath the surface, Marx and Freud and science were being replaced by a neoliberalism and neomedicalism. Today’s recovery movements and trauma focused therapies in mental health care are cut from the same cloth as the pharmacotherapies they oppose. Both appeal to operational criteria, both shun judgement, both play by the same rules.
There is no better example of this than the transformation of Buddhism into McMindfulness. Buddhism was an intensely moral exercise; McMindfulness is amoral, a product that needs to make its way in a market.
We all now sign up to the dictatorship of procedure. To being managed. To an imprisonment in an Iron Cage. This becomes clear when someone like Roy Porter semi-endorses Prozac.
I wanted to hear him say there is more to life than this. But if he had, it might have sounded like Chris Patten, the last British governor of Hong Kong who, recently protesting about the encroaching of Chinese procedures on Hong Kong, said Britain should stand up to the Chinese as a matter of honour.
Honour and sanctity and virtues like these made sense in the world of Charles I but what could they conceivably mean now? The good official, the ethical official is the one who keeps to the rules, to the procedures, even when lives are going up in smoke.
The Theory of the Managed Enterprise
Government is now a business, a management exercise, rather something visionary. We have rulers rather than leaders – technocrats a.k.a. bureaucrats.
In The Theory of the Business Enterprise, Thorsten Veblen said business and science are not good bedfellows. The scientists want to pursue things that interest them. The businessman wants to maximise the opportunity to make money from the product on the market rather than explore one that might not make it.
Science was robust enough to survive this tension until businesses became corporations (bureaucracies) after the War. The science now, at least in medicine, is totally managed. The new dispensation wants technicians not visionaries. And as for ethics, and morality, it seems a managed scientist like Peter Kramer has no difficulty with the entire literature being ghostwritten and all data being sequestrated and everything possible being done to sell the product – even as the bodies go up in smoke.
But you’d have thought someone like Roy Porter might have said – wait a minute, what about the Holocaust or was that all Fake News?
The next instalment might or might not clarify some bits of this
Even the most educated, most brilliant, of persons, have blind-spots with far reaching doom for the masses…?
It does seem inconceivable that in the history of man-kind and it’s well-being, that super-duper brainy/educated people completely lose the plot when faced with science and morals –
The whole gamut of people who should have interesting ideas and much to say on the topics of what is best for the people –
What is best for the people does not come from educated experts in our chosen subjects, is it fair to say, that the most outspoken and the most generally heard are those leading the way with their contentious ideologies which make people wriggle and squirm, often in embarrassment, but, mostly at their sheer ignorance
I don’t know what is worse, the general malaise about true science and data, or, the over-riding pontifications of those at their peak obscuring the vista
Does death, sound offensive; is it too profound a concept that makes leaders shy away and prefer not to talk about it – are the providers of our science, too innocent, too optimistic, too romantic, and, therefore, remain forever closed to things that a huge population are actually quite willing to discuss …
If there’s a mountain to climb, we climb it, whilst the whole ‘romantic’ brigade stumble and tripp in the foothills.
Annie
I think you are missing what worries me. We had loads of experts going on about things and doing great harm – but they’ve largely gone silent. With all the babble around the place it doesn’t sound like silence, but it is. The greater the babble, the white noise, the less the signal. I’ll push it a little further – even the “discourse” on Mad in America is little different to the “discourse” put out by Medical Colleges in Britain or Medical Associations in America. There is an equal lack of judgement on either side – a lack of reaching beyond the discourse. This may become clearer if there is ever a part 2 to this post
D
What are we afraid of? Ourselves? Lessons from the past are never totally learned, they happen over and over again while the same thing is uttered, ‘never again’ – until it serves to do it again. Thousands of people were experimented on by Nazis but eugenics wasn’t invented by them, and for some reason Jews are being targeted again in UK while some politicians seem to have been let off by use of yet another ‘rule book’. Decent behaviour relies on the rule book.
There are populations in many countries which are overtly ruled by dictators where some citizens (and perhaps more don’t) claim to be better off as a low level of ‘happiness’ is gained from being free of utter poverty – of being ‘cared for’ by the great leader , in exchange for giving up freedom of thought or power or sharing decisions over policies. As well as a pretence of being benign they rule by having minor officials use a rule book ;creating fear and a pretence at child like dependancy . . In ‘democracies’ there is a different more covert way of ruling over citizens including by offering ‘happiness’ and security, physical and psychological. There are now international tables to define the population’s ‘happiness; scores, Denark tops. The latest piece of ‘advice’ from the govrnemnt is to tell us how many hours sleep we ‘should’ have…
The West is outraged about the ‘re-education’ programmes groups are being subjected to in China. But there is very little criticism of the mindless nonsense of mindfullness being spread around schools starting with very young children. Parents are obliged to take a note if they want exemptions from this brainwashing being promoted with massive amounts of government and private funding. Fear is a factor – who wants their children to take the brunt of standing out – just as it was for those who had to take a note to exempt them from saying ‘prayers’ in school. The training is spread in a domino effect – trainers train trainers train trainers…Some schools of Therapy declare that narratives are co-constructs which underpin a successful ‘treatment’ they are no longer the sole experience which belongs to the ‘client’. A life is invented which is shaped together with a therapist – pompously claimed to be both science and art. One of Kafka’s books ‘Metamorphosis’ is the book of the week on R4 this week by the way. (replays on R4Sounds). the most haunting for me is one where the character is imprisoned without understanding what is going on. I don’t agree that we all ‘sign up to being managed’ though, I know it it would make no difference if I for example, shut up, trying to escape from the cage altogether seems pretty impossible for most of us living ordinary lives dependant on bureaucracies which can deny sickness benefits to suffering people or leave people dying on streets or make older people doing tough jobs work longer , whether pure science or social science what’s the point of it if it .
David
I perhaps wonder whether what what see is basic errors repeated in different permutations over millennia. We have belief systems and we have belief systems manage by bureaucracies deciding what revealed truth is – and we have vested interests: the French state before revolution a morass of privileges, franchises etc sucking dry ordinary citizens all of which looks much like the present in different dress. We have dangerous revolution in mass communications (once the printing press), now the internet. We have the persistent culls of humanity by potentates (who may be marked more by low cunning than intellect), we have the three wise monkeys from mediaeval Japan, we have the Emperor’s new clothes from nineteenth century Denmark, we have the eternal verities of Dickens’s Circumlocution Office, and of course we have ‘vorsprung mit Technik’. And perhaps it just churns round and round. I guess what might be disturbing about Porter is that a man of intellect could see Prozac as anything other than the latest craze, like hoolahoops and yo-yos when we were children, but more dangerous. It think the deference to bureaucracies (particularly by politicians) in the last three decades has become very dangerous: they hide behind expertise all the time and the expertise is largely junk just because they never bother to challenge it. The bitter lesson of history is that we never seem to learn anything from it for more than 5 minutes…
John
Clearly on the one hand human nature doesn’t change and everything repeats. The Thirty Years War just before Charles got his head chopped off doesn’t say much for the moral order in place before 1649 but just as the Atom Bomb changed everything, and perhaps there is some medical equivalent like the Human Genome Project, so also the Holocaust as a manifestation of the capabilities of bureaucracy – management – changed everything. Its now possible for us to be controlled in a way never before possible. We have also hit inflection points with Life Expectancy falling and perhaps rates of developmental disorders mushrooming that seem to me to have changed the dynamic. More next week
D
No, of course, we are into some appalling new permutation…and one thing we are left wondering is how random, how deliberate – a frightening mixture of both?
This echoes the Holocaust dilemma – how much was it deliberate malevolence and how much efficient bureaucracy.
D
I found “Something Happened – to Science and to Us” easier to follow than this piece, which is certainly thought provoking. If I could tie the two articles together, I would say that there is another tension in modern science and medicine, especially when it comes to topics like diet, GMOs, heart disease, and vaccines. On the one hand, doctors and scientists have certainly become technocrats, but on the other hand, of the commercialization of their fields, they are motivated to appeal to authority and hierarchy to push their claims. Some aspects of science and medicine have become very cult-like, with questioning their claims or making statements outside the standard dogma, even by scientists and doctors, amounting to heresy and accusations like “you don’t understand science” or “you’ll kill millions of people!” When you start hearing things like, “The science is settled,” they you know it’s no longer based on science but has become akin to religious dogma. Another doctor who is dealing with these issues, albeit in a straight-forward and sometimes humorous way, is Dr. Malcom Kendrick, a Scottish doctor who has been convincingly arguing for years that cholesterol does not cause heart disease. He recently dipped his toe into the vaccine debate (I’m not sure why he decided to paint that target on his chest) and makes similar statements about science that becomes cult-like. I highly recommend his blog as a supplement to Dr. Healy’s blog.
I’m happy to endorse the claim that Malcolm K is more humorous and more readily understandable than I am and that his arguments about cholesterol and lots of other things are pretty sound and his blog worth reading. Like Keith and I suspect many others, I have wondered why he has painted a target on his back, saying what he has recently said about vaccines.
D
Malcolm Kendrick’s blog article on vaccines is accessible via this link: ‘My feelings about the vaccine debate’: https://drmalcolmkendrick.org/2019/07/09/my-feelings-about-the-vaccine-debate/
Also consider this article by Australian doctor Aniello Iannuzzi, i.e. ‘Vaccine vicars and the immunological faith’: https://insightplus.mja.com.au/2019/22/vaccine-vicars-and-the-immunological-faith/
Iannuzzi’s article isn’t ground-breaking, but at least he touches on how complex vaccination schedules are becoming, saying “The ‘Church of Vaccination’ is not what it used to be. While I remain strong in faith, it would not take much more red tape or complexity for me to defrock and leave the others to administer the good oils”.
What staggers me is that the medical profession has generally stood by while vaccination schedules have blown out of sight, just look at all the vaccine products and revaccinations on the Australian schedule for instance, which is impacted by the coercive ‘No Jab, No Pay’ law: https://beta.health.gov.au/health-topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule
Citizens such as me, who are questioning the ever-increasing vaccination schedules, are reflexively labelled ‘anti-vax’, and are under constant threat of censorship.
A recent BMJ article headed ‘Social media: suicide promotion and anti-vaccine content must be banned, says BMA’, reports that delegates at the recent British Medical Association annual meeting had backed a call for government standards to force social media companies to “prevent the dispersal of false or misleading information on the effects of vaccinations.”
Who decides what is “false or misleading information on the effects of vaccinations”? From where I’m standing, there’s some very questionable information on vaccination emanating from ‘the authorities’ and they must be accountable, but this is very difficult to achieve in the current hostile and intimidating climate.
In my opinion, we are in the midst of a major global over-vaccination scandal, it’s way past time for an independent and objective examination of vaccination schedules, and exposure and consideration of the conflicts of interest which have influenced these bloated schedules.
Thanks very much for the links Elizabeth. Apart from the information about vaccines in general which is useful two things jump out – seems there is much vitriol and bullying goes on in Doctors.net against anybody who questions vaccines. The site is closed to the public – doctors do seem to like setting up these exclusive societies… so debate is closed down amongs themselves as well , unless they have the gumption to speak publicly anyway.
Why don’t those who are speaking out individually get together – in the open not behind closed doors. There must be so many all saying the same thing by now?
And I just wonder how an ‘independant and objective examination of vaccine schedules…’ could be set up as is desperately needed as you say.. Who would decide the examiners and their ability to do the job objectively – both in relation to their credentials in the science and being able to deal with the vitriol they would attract? I hate to think what the future outcome of this overload will be for children
Suzanne and Elizabeth
These are all good points. Too good not to have. But I don’t want the post to centre on vaccines. It asks what happened that has produced the situation we now have with adverse effects. Why 30 years ago or so, did we switch from recognising adverse effects within a 1-2 years of a drug being on the market to having difficulties recognising them 20-30 years afterwards.
D
David, you say your post “asks what happened that has produced the situation we now have with adverse effects. Why 30 years ago or so, did we switch from recognising adverse effects within a 1-2 years of a drug being on the market to having difficulties recognising them 20-30 years afterwards.”
You answer this question yourself in your post: “The science now, at least in medicine, is totally managed. The new dispensation wants technicians not visionaries. And as for ethics, and morality, it seems a managed scientist like Peter Kramer has no difficulty with the entire literature being ghostwritten and all data being sequestrated and everything possible being done to sell the product – even as the bodies go up in smoke.”
‘Science’ has been hijacked by business, and the focus is on selling the product and protecting profit, they don’t want to acknowledge adverse effects that threaten the bottom line and future markets…and they have no qualms as “the bodies go up in smoke”.
David, in your post in relation to science you say: “The pace of advance picked up relentlessly from the 1940s. The atom bomb turned the world upside down. We crossed a threshold and now we for the first time posed a greater threat to Nature than Nature posed to us.This was at least as obvious in medicine, as in any other branch of life, which from the discovery of DNA to the Human Genome Project seemed to be handing us the means to remake ourselves. We could make the New Man, and be better-than-well. But could science, even as epic as this, be the source of our problems?”
So do we pose a greater threat to Nature than Nature poses to us?
Something spectacular that occurred in the 20th century is global population growth, see for example the graph in this Quora post, Growth of World Population and the History of Technology: https://www.quora.com/What-was-the-world%E2%80%99s-population-10-000-years-ago
It’s interesting to consider the impact of science and technology on global population growth and what it means for global sustainability, now and going forward.
In recent history ,Tony Blair was labour prime minister from 1997 to 2007 when one of the biggest reforms of the NHS since 1945 was introduced – specifically described as Managerial Reforms. Many doctors were outraged about the top down management of their work which took away individual decision making as cost became the primary consideration in what was by then termed ‘the market’ The nineties were described as the ‘naughties’ when parts of London was awash with money and youngsters working in the stock exchange behaved like making vast amounts of money was a joke.. Values, morality went out of the window during this decade.The Blair campaign was run like a rock concert ‘things can only get better’ played endlessly. Blair changed the NHS for ever from a real socialist endeavour to one based on bureacracy and money. He is also a committed Catholic. It would seem as though socialism and religion had lost their soul to money and the determination to change society from fuddy duddy to sparkly new models by a new generation of bright young things , maybe importantly with with what many saw as a charismatic leader running the show. Could the Blair legacy be partly accountable for neglecting drug harms? Maybe being managed to the nth degree becomes a habit difficult to break. Everything else was managed but not the pharmaceutical industry or was it part of the ‘market’ as well?.
While I think you are right about management and the NHS, this has nothing to do with Blair or Clinton. Corbyn and Sanders would have produced the same outcome, as do Macron and Trump. In the 1960s we could recognise changes in hair and DVTs on oral contraceptives or tardive dyskinesia on antipsychotics within months of these drugs being launched, now across the board with drugs it can take 20-30 years to make a link. Why and what to do about it?
D
Is it “making the link” that has changed or is it, quite simply, that “the desire to acknowledge the link” has been lost? Is it true that doctors are safer NOT noticing the suffering? If so, in what ways are they safer? Is it purely a clamp down from the top which leaves us, the patients with such a small voice which the ‘top layer’ feel they can ignore?
To my mind, every level has a responsibility to speak out about the problems that they encounter – that includes us, the patients, as well as doctors at every level and all the way up to, and including, the pharma companies. Each level should be reliant on the others to form a strong chain. So where have we gone wrong? We have become a nation where individuals care more about their own interests than about what is best for the community/crowd/humanity. The more we have, the more selfish we become and the less we are willing to share and take responsibility for our actions. Greed has a lot to answer for this in so many ways.
How to change things? I guess if we knew the answer to that one we’d be ready and willing to change the world! The easiest way to bring a community together is through a ‘disaster’ of some sort. We now have a ‘disaster’ in medicine, but due to those who hold varying thoughts being unwilling to come together, we are very far from having a ‘medical community’ working as one.
Mary
PSYCHOPHARMACOLOGISTS – 4 Sep 1998
by David Healy (Author)
https://www.amazon.co.uk/Psychopharmacologists-Interviews-David-Healey-Healy/dp/1860360084
Synopsis
This is a collection of interviews with 25 leading figures in the field of psychopharmacology – mind altering drugs. The interviews cover the history and development of the major drugs in the field as well as their marketing usefulness.
Comment:
A solid oral history of a peculiar profession.
…..>
The ideal companion piece to this work will be published about 25 or 30 years in the future, and will be based on interviews with researchers who were raised in the mileux created by the founding fathers but who have suddenly acquired incredibly more powerful experimental tools and equipment. However, when that work is published circa 2025, don’t be surprised if mental illness is still not fully understood.
I guess it’s been true all along – some believe and others don’t, whether it be of religious, scientific or any other beliefs. Those who believe can either believe without question or believe “because it bodes better for them than not believing”. Unseen things can be questioned but neither proved nor disproved. Science is meant to be definitive but, it seems, the ‘truths’, here too, now depend on the observer’s point of view.
Where do we stand in all of this mess – are we ‘believers’ in the science of “what does good can also be bad”? or “what does good for many is good full stop”?…….. or are we in yet another category of “I know because I’ve been there and my belief in ‘adverse reactions’ etc. is unshakeable”.
It is my belief that unless we can accept that very many people do not, yet, fully believe that doctors can be wrong; unless we are willing to accept how difficult it is for those who have not witnessed the possible deceits in medicine to accept that what we have witnessed is not a rare occurrence but happening worldwide; unless we are willing to discuss openly with the wider community that all is not as well as it should be in the world of psychiatry ( just as in many other ‘worlds’) then we are not going to move very far forwards.
As B. Franklin said (about a different, but equally important, issue) – “Justice will not be served until those who are UNAFFECTED are as OUTRAGED as those who ARE”.
Pharmacists who are being employed in surgeries might be able to give valuable input in time if they arre not undermined further.
In Pulse Med Mag ‘ July 15th 2019 article by Lea Legraien ‘GPs Ignore Pharmacists Advice – ‘because it is unlikely to benefit patients’. One GP said ‘GPs tend to ignore recommendations because they were more technical (!) and unlikely to lead to patients’ benefit, such as switching on patients’ statins’.-
Ref – 3D Study Society for Academic Primary Care’
Fewer than half pharmacists’ recommendations are acted on. How can we know whether this is turf wars or a true reason for elbowing pharmacists out of assisting with prescriptions by using their specialist knowledge There is supposed to be collaborative working but this looks like it could be another situation of protecting the hierarchy in surgeries . Specialist nurses have also been undermined and seen as subordinate by some GPs.
Susanne
I don’t know what there is in Blair being a committed Catholic. In June 2007 I recall as a tourist attending a Catholic service at St Albans Abbey – which had been ecumenically loaned to them for the afternoon. The priests were seething at the new adoption rules that Blair’s government had just instituted. If my memory is correct he resigned as PM days later and I think simultaneously announced his intention of joining the Catholic Church. I think what Blair was really committed to was screwing everybody. And no doubt he was reading his opportunities with especial deviousness.
I also recall a PM’s question when he was given the planted question how much the government was spending on statins – he gave a figure I think of £800m, but said he hoped it would soon be even more.
So what makes it possible for , say one person to realise and state unequivocally what they are seeing is real and another to deny it is there? Some obviously simply don’t see it – they have a block against seeing it. It’s not always just being perverse or afraid to go against the grain.. What sensitizes some doctors to believe what they see is serious effects of drugs and others even parents to deny it can be true What makes them so different?.It can’t just be evidence as they have the same evidence, can it be psychological some kind of group think?
Decades ago it was common knowledge that some drugs caused horrible side effects , they were so obvious. But David has pointed out that it is not that the drugs are more complicated these days, something else is happening, a medical-pharmacalogical silent spring controlled by drugs companies.(if I have it right). Wev’e yet to reach the stage where the perception is changed from can’t believe so can’t see because in medicine something so terrible is happening – but can be hidden behind the undeniable good things.maybe there has to be a critical mass even a disaster (even more obvious ) – I guess ,’they’ have learned the lessons from history, management plus opportunity have never been so possible when our data is so accessible to drug companies and whole populations can be used as research fodder to invent yet more stuff to pump into us I.m sure the money going into pharmaceuticals would be shifted pretty quickly if another war was likely. They are the peacetime equivalent to armanents factories anyway.
Allowing that David did not want this to be focussed on vaccines I do note two significant moments: the creation under President Obama (O’Pharma) of the Global Health Security Agenda (2014-6) and the identification by the WHO at the beginning of this year of the “Vaccine hesitant” as a threat to global health – with measles being apparently the new WMD. These are obviously strategic initiatives: indeed we are even being told that these are strategic initiatives. At the same time we are coming to the point with the systematic vaccination of pregnant women where infants will become pharmaceutical wrecks even before they are born.
https://www.bmj.com/content/366/bmj.l4454/rapid-responses
We are witnessing the creation of the chronically sick before birth, and this is worth financially much more than just the vaccine sector (presently about 60 billion dollars a year?) to pharma.
I remember seeing many years ago (black and white TV) a documentary about the Victorian obsession with trying to invent perpetual motion machines, but the problem of course was that more elaborate and ingenious they became the greater the level of friction and the more unwieldy. A free spinning wheel would have been about the best. And this I guess is the position with the dream of pharmaceutical health: the more we add on the worse it gets.