Tuesday, August 21, 2012

Dear Dr Scientist...

I have a question.

It's a fairly specific question, and I'd quite like a specific answer. The only problem is that I have a feeling the answer to my question is just going to be more questions.

It would be great if that didn't mean we quickly rush to a 'oh well, there's nothing we can do' position too quickly (or at all, if possible).

Here's the question.

Why are we not spending time and money trying to ascertain who the medically vulnerable folk are in our population?

My logic (honed by 44 years of thinking, reading and writing... OK, most of it has involved less hefty content than you are used to, Dr Scientist, but bear with me) says, medical action based on statistical success is awesome, as long as you don't fall into the nether regions of those statistics.

Birth control success at 99.9%, feels great each month when you use your birth control and you are not pregnant. The consequences when you are the .01%... fairly large.

Penicillin allergy risk sits at about 10%.  That's great for the 90%, and heartening that it's the overwhelming majority. It sucks quite substantial balls for the 10%, especially for the 1% of that 10% who may well die from their reaction. It has massive consequences especially for the babies who find out the hard way penicillin is not for them.

A 'very rare' vaccine reaction is listed by the CDC (Australian figures are much harder to source, Google wise... sue me, I'm a kids TV writer) at anywhere between 1 in 100 000 or 1 in 1 000 000... quite a broad range that changes vaccine to vaccine. Also, given that the US has a population of close to 315 million, that's a hell of a lot of people living with 'rare' consequences.

The World Health Organization says it's not possible to predict who will have a mild or serious reaction to a vaccine, and my question, Dear Dr Scientist, is... why not?

We can grow a human ear on the back of a rat. We can land a rover on Mars in real time. We made a sheep without the need for two sheep, soft lighting and a Barry White CD... why can't we work out who is vulnerable?

The cynic in me (or is it the realist) says it's all about money.

It's cheaper to deal with the aftermath than to investigate avoiding the risk. This is especially true if we do not acknowledge a lifelong disability with higher numbers than relatively common conditions (like diabetes or cancer) as a possible consequence of taking on the risk.

The peacekeeper in me wants to believe that governments give more of a crap than that.

Surely, public health, especially the health of children and adolescents comes ahead of financial gain. Surely, a growing and expensive crisis in education and social services is something a government would want to avoid.

The parent in me just wants to protect my child. The human being in me wants to protect other children as well.

And yes, I know that vaccines, penicillin and birth control are protecting children too. Personally, I think they are fab, and should be there along with lots of other procedures that make life better.

But, they need to be safe.

How do we make them safe?

I'm not a scientist, but I'd suggest keeping manufacturers accountable, separating 'testing' out of the mandate of the manufacturer and into the aegis of an independent body, and increasing transparency about how and why ingredients of all broadly administered medications (or whatever the correct word is) are chosen and approved.

Moreover, I'd say, if you want people to continue to use medications with confidence, find out who is at risk and encourage them to make different choices.

The 99% (or 75% or the 10% or whatever) who can go ahead with confidence, then should go ahead with confidence.

The rest can make a different choice.

We should have the right to make a different and accurately informed choice. Billy needs the right to make a different choice. We are not the only ones who need this right.

Just because we are not the majority, doesn't make our safety any less valid.

I remember, as a kid, reading somewhere that you have more chance of being kicked to death by a donkey than being killed in a plane crash. And yet, every year, hundreds of people would lose their lives in spectacular plane crashes.

Interestingly, in a valid quest to ensure people felt more confident about flying, we improved aviation safety. I'm guessing that improvement took a lot of time and money. I'll bet it also hurt someone's hip pocket, but at the same time, it felt like responsible progress.

It wasn't anywhere near the majority of travelers who lost their lives in crashes, but it was some. Death or injury as a possible consequence of air travel probably influenced people to make other choices about travel methods. Especially when the news kept flashing up pictures of flaming fuselages.

I wonder what's stopping us shining a similar light on safety in the medical industry?

I also wonder what all those angry donkeys are doing nowadays...

1 comment:

Lisa said...

The donkeys are still killing and maiming at the same rate. There has been no improvement in donkey safety. Donkey deaths aren't newsworthy.
The NDIS may or may not support those maimed by donkeys, however the cost of the NDIS has possibly been calculated by the bean-counters-that-be to come in at less than the cost of improving donkey safety.

And the catchphrase of the decade is 'Risk Management', long may it rot in hell.

Changing the subject to grammar, I once phoned a euphemistically titled 'resource allocator' to ask if they would allocate a temporary replacement for a sick colleague, and was told "no, we'll just risk-manage that". A VERB! Who knew?