A thought provoking editorial, indeed. I liked that last sentence
that needs some elaboration, though. “While waiting for the science of
dementia to catch up there is scope for more public pressure—this time for
the universal adoption of a humane patient pathway for people with
dementia.” Public pressure does work in many areas of human endeavour.
May your call for public pressure for humane care build up over time
just as that of a young MP, William Wilberforce, who took out a march in
Edinburgh calling for abolishing slavery, nearly 50 years before the final
bill “Slavery Abolition Act” was passed in 1833 in the House of Commons-
just three days before Wilberforce died prematurely? When Wilberforce took
out the procession people laughed at him and advised him to pack up and go
home as his plea could never succeed since the British economy depended on
slavery those days. His mentor in politics, William Pitt, another liberal,
as Prime Minister, did help Wilberforce. Pitt also brought in voting
rights for women at a time even educating women was looked down upon! Your
wish for a new science of dementia is well founded and should succeed.
What worries me more is that we do not have any science of man in the
first place, leave alone dementia. All our tall claim of evidence based
medicine becomes evidence burdened in that sense. Today patients survive
any illness thanks to the inbuilt repair mechanism, despite the efforts of
doctors and hospitals.
No great scientific brain has ever tried to unravel the mystery of
the science of man. Most of them spent their life time unraveling the
science of inanimate matter like in physics and chemistry. The same
linear, reductionist science is used to measure the unfathomable human
being-a round plug in a square hole! When we unravel the science of man,
dementia gets explained automatically. The hitch with the science of man
is assessing his consciousness, which easily would then explain dementia.
Humane care is another far cry. Man, unfortunately, is hardwired to
be homo-economicus with greed in a child for survival. Most of us carry
that childhood greed to adulthood and operate all our lives with greed as
our foundation. What man forgets is his heart, as a child, was full of
universal compassion, smiling at everyone naturally. Nature intended us to
grow up having a balance of greed in small measure for survival but
compassion in large measure for happiness. This might look incongruous but
is possible as Jesus said: “Be ye, therefore, wise like a serpent but
harmless like a dove.” A judicious mix of humility and militancy!
The Swedish Nobel committee again faltered in their 2002 Nobel Prize
for economics to Vernon Smith and David Kahneman who showed by their
“Dictator Experiments” that mankind is hard wired to be compassionate
(Homo Altruisticus). However, their experiment was basically flawed as
shown by their own colleague, John List, when he repeated the same
experiment telling the subjects that they were free to do anything and he
was not going to watch them breathing down their necks (that was the
design of the Nobel Laureates). Lo and behold! every one of the subjects
cheated to make money for himself! True culture is what one does when no
one is looking at him. Man, John List showed, is truly homo economicus.
Truth, therefore, is that we are not made to give humane care. To do that
we have to train ourselves to be humane-hard work indeed.
If my memory does not fail me, a great scientist, a Nobel Laureate,
Alexis Carrel, in his classic, Man, the Unknown (Wilco Books-page 295 and
296), had a different solution for dementia, schizophrenia and those hard
core criminal anti-social elements. He felt that it is cheaper and saner
to gas them all to end their personal and societal misery, instead of
spending large sums of money on caring for them in special homes or
prisons at the tax payers’ cost! He also felt that the abnormal people
should not be there to trouble the normal people in society. Minor
criminal acts, he felt, could be corrected by whipping alone and not
institutionalising the criminals spending money for them! I wonder to what
category that advice belongs? If an ordinary person had written that, the
world would have declared him insane. With the Nobel tag, one can write or
say anything and get away with it. I think it was Winston Churchill who
once said that in every opinion there are three aspects. Who wrote it, how
did he write it and what did he write? Of the three, the last, Winston
felt, was least important. How true?
Humane care is CARING for the patient.
Yours ever,
bmhegde
Competing interests:
None declared
Competing interests:
No competing interests
13 August 2010
BM Hegde
Editor in Chief, Journal of the Science of Healing Outcomes
Rapid Response:
We shall show mercy, but we shall not ask for it.
Dear Tony,
A thought provoking editorial, indeed. I liked that last sentence
that needs some elaboration, though. “While waiting for the science of
dementia to catch up there is scope for more public pressure—this time for
the universal adoption of a humane patient pathway for people with
dementia.” Public pressure does work in many areas of human endeavour.
May your call for public pressure for humane care build up over time
just as that of a young MP, William Wilberforce, who took out a march in
Edinburgh calling for abolishing slavery, nearly 50 years before the final
bill “Slavery Abolition Act” was passed in 1833 in the House of Commons-
just three days before Wilberforce died prematurely? When Wilberforce took
out the procession people laughed at him and advised him to pack up and go
home as his plea could never succeed since the British economy depended on
slavery those days. His mentor in politics, William Pitt, another liberal,
as Prime Minister, did help Wilberforce. Pitt also brought in voting
rights for women at a time even educating women was looked down upon! Your
wish for a new science of dementia is well founded and should succeed.
What worries me more is that we do not have any science of man in the
first place, leave alone dementia. All our tall claim of evidence based
medicine becomes evidence burdened in that sense. Today patients survive
any illness thanks to the inbuilt repair mechanism, despite the efforts of
doctors and hospitals.
No great scientific brain has ever tried to unravel the mystery of
the science of man. Most of them spent their life time unraveling the
science of inanimate matter like in physics and chemistry. The same
linear, reductionist science is used to measure the unfathomable human
being-a round plug in a square hole! When we unravel the science of man,
dementia gets explained automatically. The hitch with the science of man
is assessing his consciousness, which easily would then explain dementia.
Humane care is another far cry. Man, unfortunately, is hardwired to
be homo-economicus with greed in a child for survival. Most of us carry
that childhood greed to adulthood and operate all our lives with greed as
our foundation. What man forgets is his heart, as a child, was full of
universal compassion, smiling at everyone naturally. Nature intended us to
grow up having a balance of greed in small measure for survival but
compassion in large measure for happiness. This might look incongruous but
is possible as Jesus said: “Be ye, therefore, wise like a serpent but
harmless like a dove.” A judicious mix of humility and militancy!
The Swedish Nobel committee again faltered in their 2002 Nobel Prize
for economics to Vernon Smith and David Kahneman who showed by their
“Dictator Experiments” that mankind is hard wired to be compassionate
(Homo Altruisticus). However, their experiment was basically flawed as
shown by their own colleague, John List, when he repeated the same
experiment telling the subjects that they were free to do anything and he
was not going to watch them breathing down their necks (that was the
design of the Nobel Laureates). Lo and behold! every one of the subjects
cheated to make money for himself! True culture is what one does when no
one is looking at him. Man, John List showed, is truly homo economicus.
Truth, therefore, is that we are not made to give humane care. To do that
we have to train ourselves to be humane-hard work indeed.
If my memory does not fail me, a great scientist, a Nobel Laureate,
Alexis Carrel, in his classic, Man, the Unknown (Wilco Books-page 295 and
296), had a different solution for dementia, schizophrenia and those hard
core criminal anti-social elements. He felt that it is cheaper and saner
to gas them all to end their personal and societal misery, instead of
spending large sums of money on caring for them in special homes or
prisons at the tax payers’ cost! He also felt that the abnormal people
should not be there to trouble the normal people in society. Minor
criminal acts, he felt, could be corrected by whipping alone and not
institutionalising the criminals spending money for them! I wonder to what
category that advice belongs? If an ordinary person had written that, the
world would have declared him insane. With the Nobel tag, one can write or
say anything and get away with it. I think it was Winston Churchill who
once said that in every opinion there are three aspects. Who wrote it, how
did he write it and what did he write? Of the three, the last, Winston
felt, was least important. How true?
Humane care is CARING for the patient.
Yours ever,
bmhegde
Competing interests:
None declared
Competing interests: No competing interests