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Rapid Responses: Rapid Responses published:
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Doctors' consciences
- Kim D Miller (21 August 2006)
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China's medical system continues to improve dramatically
- Douglas Noble, Dr. Weisheng Ye - Vice-Director of Surgery Tianjin Orthopaedic Hospital, Sir Muir Gray - Director of Clinical Knowledge NHS, Dr. Jonathan Juzi - Trauma Surgeon + Associate JHF (23 August 2006)
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China's skeletons
- David J Magee (26 August 2006)
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Kim D Miller, GP Alness/Invergordon Medical group Rossshire IV17 0UN
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Considering the BMJ as a voice of medical conscience and a publication of international standing, I read this personal view with increasing dismay and distress. Considering that China has "arguably a cupboard full of skeletons" pays little regard to the continual abuses of human rights throughout China and especially in Tibet. Being a member of the United Nations they have yet to ratify The Convenant on Civil and Political Rights ( amongst others).. This is not something that should be disregarded. China may be trying to improve health care and openness but that is of little help to the marginalised races and political opponents. Can forced abortions and sterilisations ever be justified? In the same journal, the review of "OATH BETRAYED" by Jean Lenzer should cause us all to reflect on our moral naivety and to remember that 23 Nazi doctors stood trial at Nuremberg 7 of whom were hanged. Engaging with our Chinese colleages and establishing links is a positive way forward for humanity, but we can not blinker ourselves or consider it impolite to ask difficult questions. Surely as doctors we should be defending all patients, the weak and the sick. Dr Kim Miller GP Alness Invergordon Medical group Rossshire Competing interests: None declared |
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Douglas Noble, International Medical Adviser 9/F Mongkok Harbour Centre, 638 Shanghai Street, Kowloon, Hong Kong, Dr. Weisheng Ye - Vice-Director of Surgery Tianjin Orthopaedic Hospital, Sir Muir Gray - Director of Clinical Knowledge NHS, Dr. Jonathan Juzi - Trauma Surgeon + Associate JHF
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Dear Editor Our experience is that China’s medical system, despite massive adversity, continues to improve dramatically. We agree with your recent comment that China is changing and is committed to learning from the world and imparting its vast reservoir of untapped medical knowledge (1). This is likely a significant source of evidence, as yet largely unevaluated (2). We represent a medium sized non-governmental organization working within China. The Jian Hua Foundation (JHF) has worked alongside the Chinese Government with educational projects in fields as diverse as medicine and rural community development. Our experience is that there has been a continual and gradual change towards collaboration with the West and promotion of critical thinking within education. It is not realistic to assume that a country with the social and economic history that China has experienced in recent times can embrace the rigors of Western style evidence based medicine (EBM) overnight. However, there is clearly a commitment to this agenda, testified by a recent EBM conference in ChengDu City (3). This summer JHF conducted a highly successful physiotherapy workshop in Tianjin City, at the invitation of the Rehabilitation Association of Tianjin and supported by the Sino-British Fellowship Trust. This involved eight international physiotherapists exchanging ideas and Western practices of physiotherapy both in a lecture theatre environment and at the bedside. There was much to learn from each other. Our experience was that honesty about current practice was prevalent and not just a willingness to change to better practice but a desire to robustly ensure that change was the correct course of action. In fact, the main challenges were not primarily educational. They lie with the wider structure of the current health care system. For example, rehabilitation is not an integral part of most treatments (orthopaedic or not) and the insurers, in general, do not pay for it. It is disappointing that no original research articles were accepted for publication in the recent edition of the BMJ devoted to China. However, it is our hope that as we work alongside Chinese colleagues this may become a more regular experience in the international medical peer- reviewed literature. They are currently playing a slightly different game, and there is much we can learn from it. Independent from JHF, the inaugural meeting of the Sino-British Medical Union is scheduled for January 2007 to determine how best the United Kingdom can cooperate with China medically. The priority is to firstly access and assess the vast unexamined medical knowledge within China and secondly to determine how best we can work in partnership to enhance the value of healthcare together. It is hoped that this partnership (or Guanxi as the Chinese call it) will help establish a new agenda for knowledge management between the United Kingdom and China. We are still open to accepting applications from interested parties who would like to be involved. douglas.noble@dh.gsi.gov.uk 1. Rajendra Kale: Changing China. BMJ 2006;333, doi:10.1136/bmj.333.7564.0-f 2. Zulian Liu, Tengbin Xiong, Catherine Meads: Clinical effectiveness of treatment with hyperbaric oxygen for neonatal hypoxic-ischaemic encephalopathy: systematic review of Chinese literature BMJ 2006;333:374, doi:10.1136/bmj.38776.731655.2F (published 11 May 2006) 3. The 4th Asia-Pacific Conference on Evidence-Based Medicine(EBM) was held in Angel Hotel, ChengDu City from 15th to 17th, April, 2006. http://www.cd120.com/yejun/upload/web/eng/ReadNews.asp?NewsID=123&BigClassID=2&SmallClassID=23&SpecialID=0 Competing interests: None declared |
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David J Magee, GP Chessel Practice SO19 4AA
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In the Editor's choice of 19th August 2006 BMJ Rajendra Kale wrote, "Arguably China has a cupboard full of skeletons, which it needs to bury decently." The regime in the Peoples Republic of China is either the most murderous in history or the second most murdeous regime after the former USSR. Therefore this comment is indecently mild. Furthermore, skeletons are still being put in that cupboard, though as far as we can tell at a much lesser rate than under the " Great Leader" whose portrait overlooks Tiananmen Square. The PRC regime is unrepentant, unlike modern day Germany where the files regarding the totalitarian past are available for research. There may be many Chinese and China is far away but we should not undervalue Chinese lives as their own government appears to do. While few are afraid to criticise appalling regimes of the past we ought not be quiet about the current ones. It is the PRC regime itself which needs to be buried. D J Magee Competing interests: None declared |
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