Science, debate, and compassionBMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1795 (Published 31 March 2010) Cite this as: BMJ 2010;340:c1795
All rapid responses
What Dr Hegde is saying is right. We are investing more in treating
disease rather than preventing disease. I feel we need fewer than 100 drugs
to treat most diseases, but Companies are almost trying to produce more
drugs not to cure diseases but hoping to reap more money.
Competing interests: No competing interests
Dear Fiona Godlee,
Science, debate and compassion-what a beautiful title for
the editorial? If “science is
measurement and measurement is science,” as defined by Marie
Curie, where is the role for compassion in science?
Compassion can never be measured and as such is
unscientific! The whole meaning and purpose of science seems
to have been distorted today, thanks to the patent and
intellectual property rights issues introduced by Corporates
in the first place with the connivance of the government.
Today science revolves round quick discoveries, patenting
and trying to get as much money as possible. An
article in last week’s JAMA talks about the nexus between
the industry and academic psychiatry in the US. (1) It
should shake any status quoist from her/his deep slumber to
know to what level medical fraternity has degenerated!
Compassion is the one word that has no place at all either
in today’s hard sciences or medical sciences. Science should
try and understand nature and not try to teach nature some
lessons and change the way nature works.
I totally agree with the views expressed by David
Steffie Woolhandler about the Obama bill, hailed as the
civil rights bill of the 21st century. (2) In my response
last week I had noted that the bill is inadequate in every
respect. Insurance is a business; business naturally looks
for profit. (3) How can any one make profit out of human
misery unless one lacks compassion? What the common man on
the street needs is health assurance and not insurance.
Consequently, Obamacare lacks the true meaning of
compassionate medical care for all.
A good NHS model sans
its esoteric treatment modalities like heart transplants
etc. might be a better option. Most illnesses are self
curing minor illness syndromes which could make do with a
compassionate doctor and her/his assurance. About ten per
cent of the chronic illnesses and cancer are incurable,
anyway. Those patients just need “comforting mostly but
consoling always” as advised by Hippocrates.
Compassionate doctors, given ample time to “listen” to their
patients, as suggested many years ago by Professor Calnan, a
plastic surgeon, in his book, Talking with Patients, could
make the cost of medical care come down by more than 50%.
Judicious use of drugs would bring down billions of dollars
now spent in treating Adverse Drug Reactions (ADRs), the
fourth leading cause of death in the US. Drug evaluations
will have to be more scientific. The so called RCTs need
serious reconsideration. Poly-pharmacy should be strictly
However, what America needs is good health care system. They
have the best infrastructure for water supply and sanitation
but the food habits, hi-tech life style and stress levels of
the common man need to be addressed urgently if the US is
serious about improving its health status. The preserved
junk food industry should get this message loud and clear.
Human kind should try and live as close to nature as is
possible. Physical exercise is lacking in the majority of
Americans who have become couch potatoes. Life has become a
rat race in the, I owe you economy, which is one of the
important causes of killer degenerative diseases. Obesity
has become an epidemic.
Scientific world should learn a lesson or two about true
compassion. Recent study by Professor John List of the
Chicago University has upturned his senior colleagues’
observed “Dictator Experiment” studies which showed that
mankind is hard wired to be altruistic. Although those two
colleagues, Vernon Smith and David Khahnman, got the 2002
Nobel for economics, their studies were completely flawed.
Professor John List showed by similar experiments,
conducted under real life situations, that mankind is
“homo-economicus,” far from being “homo altruisticus.” (4)0
Poor John List was not recongnised by the Swedish Committee.
He is, however, happy as he believes in Winston Churchill’s
dictum which states that: “it is better to deserve than to
get.” John deserves not just the Nobel but much more for
showing the truth, which is being seen in every walk of
modern day life. Humans are greedy; science
and medicine not excluded. So Fiona could take heart
to know that compassion in medical care would be a far cry
in the wilderness. Arthur Schopenhauer’s dictum, in the
caption above, is the ideal in life.
1) Insel TR. Psychiatrists’ relationship with
pharmaceutical companies-part of the problem or part of the
solution. JAMA 2010; 303(12): 1192-1193.
2) Himmelstein DU and Woolhandler S. Obama’s reform:
no cure for what ails us. BMJ 2010 340: c1778.
3) Hegde BM .With malice towards none.
4) Levitt SD and Dubner SJ. Superfreakonomics. 2010.
Penguin, Allen Lane.
Competing interests: No competing interests