So, can we lock him up now?

[lederhosen]

I already knew Andrew Wakefield's paper on the MMR vaccine - the one that caused vaccination rates to plummet in the UK - was based on a sample of just twelve children, and that Wakefield failed to disclose a major conflict of interest. Via james_nicoll, it turns out that even those twelve cases aren't trustworthy:

In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

Despite involving just a dozen children, the 1998 paper’s impact was extraordinary. After its publication, rates of inoculation fell from 92% to below 80%. Populations acquire “herd immunity” from measles when more than 95% of people have been vaccinated.

Last week official figures showed that 1,348 confirmed cases of measles in England and Wales were reported last year, compared with 56 in 1998. Two children have died of the disease.

At the very least, I hope Wakefield is never allowed to practice medicine again. (This sort of thing, BTW, is why House makes me uncomfortable - I've no doubt that Wakefield has genuinely convinced himself that there's a link, and therefore the ends justifies the means; unfortunately, in the real world, doctors with hunches are often disastrously wrong.)

Meanwhile, the fire stories from Victoria are just awful. Now up to 84 confirmed dead, probably more. Called my stepmother, and her family are currently okay; will check on my sister-in-law tomorrow.

Comments

[cerebresque.livejournal.com]

(This sort of thing, BTW, is why House makes me uncomfortable - I've no doubt that Wakefield has genuinely convinced himself that there's a link, and therefore the ends justifies the means; unfortunately, in the real world, doctors with hunches are often disastrously wrong.)

Per season four episode six, it would appear that House agrees with you where ends and means are concerned.

[lederhosen.livejournal.com]

At least where the doctor in question is somebody other than himself... I'm pretty sure I've seen several incidents where House let his own hunches override a lot of the usual safeguards against malpractice, but I can't cite them just now.

[cerebresque.livejournal.com]

...every episode, I should think. But while that's true, I would note that every specific time I can recall House deciding that the ends justified the means, the ends were still "the good of his particular patient", rather than the 4x6 example quoted above or Wakefield, who were using their patients as instrumentalities towards other ends. So that seems to be the line that he draws.

(Of course, being somewhat of a cynic with regard to where the boundary between safeguards against malpractice that protect the patient from harm and the safeguards against malpractice that protect others from legal liability tends to be, vide. for example the unavailability of experimental treatments even to people whose choice is "...or death", my sympathies lie several steps House-ward of yours, I suspect.

If slightly bounded by the non-fictional world geniuses with his consistent success rate...)

[lederhosen.livejournal.com]

You might be surprised - I'm very much in favour of letting competent adults make informed risk decisions, and I'd much rather concentrate on improving the quality of information available to them than on restricting their choices.

Problem is, even if RL had a few House-level medical geniuses around, it's not practical to say "ignore the rules if you're a genius". People just aren't that good at self-evaluation. So we end up with a tradeoff between letting a handful of geniuses save a handful of people by breaking the rules, or letting a truckload of overinflated 'geniuses' kill people through whatever brand of quackery they firmly believe in.

(more later, bus time.)

[lederhosen.livejournal.com]

The other thing that bothers me about House - I think I mentioned this on Turnberry's journal - is that while he always works for the good of the patient, I'm not convinced that really constitutes 'ends'.

My interpretation (usual caveats apply) is that House is a control freak who likes having and exercising the power of life and death, and saving people's lives is one of two equally effective ways of basking in that power - maybe a bit more enjoyable because it's a harder challenge, but actual benevolence towards his patients is relatively low on the list compared to the fun of problem-solving.

It's still good news for his patients, but he's a little too close to a Harold Shipman type for my comfort.

[cerebresque.livejournal.com]

Given the evidence you have, you might very well be right.

Of course, as I think I might have mentioned before, given the choice and the choice of making the choice, I'll take that guy in a heartbeat myself. (I'll take the non-benevolent problem-solver over someone who'll empathise me to death, any day, and I have a profoundly cynical view of the practical value of active benevolence.)

[lederhosen.livejournal.com]

I might take the same choice, but I don't have to be comfortable about it ;-)

(I think this is an example of 'hard cases make bad law'; there are fictional settings where doctors like House can do a lot of good, but IRL letting doctors run amuk tends to end up in bad places.)