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Social care: pressure mounts for urgent and radical reform

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4564 (Published 05 July 2019) Cite this as: BMJ 2019;366:l4564

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Anita Charlesworth: We need a social care system that is as much a source of national pride as the NHS

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Response to John Stone’s “Re: Social care: pressure mounts for urgent and radical reform - the cost of Brexit is a blip compared with the cost of the unexplained surge in ASD” (2019 Jul 23)

I write papers involving in-depth analyses. Currently, I am working on a 4-part series on Polio, Part 1 completed (Harrison, 2018). On my to-do list is the history of ASD diagnoses. Below I list some of the KNOWN causes of Stone’s “unexplained surge.”

HIDING IN PLAIN SIGHT

The late Autism researcher Lorna Wing (2005). wrote: “Nothing exists until it has a name.” As an example, in 910 treatise, the Persian/Arab physician, Al-Razi, noticed that a disease, up to then considered one, actually was two separate diseases, smallpox and measles (Cliff, 1993, p.52). So, did smallpox or measles suddenly develop in the 10th Century?.

Contributing Factors to Diagnoses of Autism Spectrum Disorders:

Leo Kanner’s 1943 article introduced the diagnosis of Autism and gave estimated statistics (based only on his own office practice); but in 1971, at a conference, he admitted that he rejected minorities and working class whites, believing it only a diagnosis for children of educated whites.

A number of journal articles and other reports, going back to early 1900s, used mental retardation and childhood schizophrenia diagnostic categories; but if I gave the listed symptoms without the source, they would definitely be categorized as Autism Spectrum Disorders.

A few described cases from various sources from the 19th Century and earlier would similarly be today diagnosed as ASD.

Psychiatry was a relatively new profession, only developing the last two decades of the 19th Century, so nearly impossible to know how people with problems would have been diagnosed earlier.

Prior to World War II, there were few to no social services in the U.S., the age required for school attendance was lower and children with problems were either just kicked out, some finding menial jobs, some institutionalized.

After World War II, with the rise of America’s middle class and family politics, more attention was paid to children. After the 1957 Soviet launch of Sputnik, more funds and programs and emphasis on public education was developed and the minimal age for leaving school increased.

Psychology became a popular degree in American universities and we began churning out psychologists, school counselors, and more psychiatrists and, of course, this led to more work needed for them.

Originally ASD was diagnosed by psychiatrists using various techniques; but gradually standardized diagnostic instruments were developed, allowing for easier and quicker diagnoses by others.

In 1986 the Federal government passed legislation for grants to local schools for special education, dealing with children with problems. In the early 1990s this was extended to include ASD.

Studies have found as the number of cases of ASD increases, the number of cases diagnosed as mentally retarded or childhood schizophrenia have decreased, at least, partially a response to availability of funds.

What was originally classical autism cases, became Autism Spectrum Disorders. Asperger’s wasn’t added until 1994 and there are cases of men in their 70s who have been diagnosed with Asperger’s. ASD includes kids with a variety of different signs and symptoms; but with some in common. As an example, in the 19th Century, high levels of white blood cells were originally thought to be signs of infectious disease; but then discovered to be cancer, so they were included in the category Cancer. Certainly doesn’t mean that cases of cancer were increasing, just another group was added. Blood cancers differ in many respects from solid tumor cancers; also have signs and symptoms in common. Another example, imagine that medicine begins looking at respiratory diseases, first including just asthma and pneumonia, then later emphysema, chronic obstructive disease, cancer, etc. Imagine the government creates a separate institute with lots of funding and grants, both for research and education, ending up with more and more respiratory therapists, pulmonologists, and researchers and, of course, diagnosed cases.

Increased awareness/screening/surveillance.

Childhood mortality has been decreasing over the past century. Children who would have died at birth or early on, e.g., low birthweight, especially very low birthweight, and genetic disorders, now can live long lives; but often have physical, cognitive, and emotional problems.

A relationship has been found between ASD and children born to older parents, more mutations in eggs and sperm.

We live in the age of a therapeutic society. More and more people are being diagnosed with something. If this continues, no one will exist who doesn’t have some medical/psychiatric label (e.g., Brownless, 2007; Hadler, 2007; Payer, 1988, 1992; welch, 2011).

Since World War II over 85,000 new chemicals have been introduced into our environment with little to no oversight. Before then, despite overwhelming medical science, lead was added to gasoline. A mass of studies has found that HIGH levels of lead in the blood of fetus and children results in lowered intelligence, behavioral problems, etc. And studies have found some post-war chemicals “cause” ASD when fetus exposed. High levels, not the minuscule levels of various additives in vaccines. So, yes, one can attribute some increase in ASD to the environment, either interaction with genes or by itself; but this doesn’t change that the vast majority of cases can be explained by the above.

I believe in community and wish a society where all human beings are treated with dignity and resources provided for them to obtain whatever potential they have, so I support evermore funding for children and adults labeled with ASD; but also cerebral palsy, Down’s Syndrome, etc. All lives are precious.

And we can “easily” afford this if our governments didn’t continuously lie to us about threats from abroad, while acting on behalf of corporations (access to raw materials and selling of weapons), resulting in CIA, MI6, and military spending trillions of dollars, risking our loyal military, and killing, crippling and impoverishing people in developing nations who were NEVER a threat to us. Of course, by killing them, we become the enlistment stimulus for terrorist groups, which we then claim the need to defend against, a vicious circle. Trillions of dollars that could have benefited us and used for real foreign aid (Blum. 2003; Butler, 1935; Gaffney, 2019; Schlessinger, 2005).

REFERENCES:

Blum W (2003). Killing Hope: US Military & CIA Interventions since World War II. Available at: https://www.cia.gov/library/abbottabad-compound/13/130AEF1531746AAD6AC03...

Butler, Major General Smedley (1935). War Is A Racket. Available at: https://www.cia.gov/library/abbottabad-compound

/13/130AEF1531746AAD6AC03EF59F91E1A1_Killing_Hope_Blum_William.pdf
[Butler is the most decorated Marine in history]

Brownlee S (2007). Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer.

Cliff A, Haggett P, Smallman-Raynor M (1993). Measles: An Historical Geography of a Major Human Viral Disease. Blackwell.

Gaffney M (2018 Mar). Corporate Power and Expansive U.S. Military Policy. American Journal of Economics and Sociology; 77(2): 331-417. Available at: https://www.globalresearch.ca/corporate-power-and-expansive-u-s-military...

Hadler NM (2007). The Last Well Person: How to Stay Well Despite the Health-Care System.

Harrison JA (2018 Nov 9). Wrong About Polio: A Review of Suzanne Humphries, MD and Roman Bystrianyk’s “Dissolving Illusions” Part 1. Science-Based Medicine. Available at: https://n1s1t23sxna2acyes3x4cz0h-wpengine.netdna-ssl.com/wp-content/uplo...“Dissolving-Illusions”-long-version.pdf

Payer L (1988). Medicine & Culture: Varieties of Treatment in the United States, England, West Germany, and France.

Payer L (1992). Disease-Mongers: How Doctors, Drug Companies, and Insurers are Making You Feel Sick.

Schlesinger SC, Kinzer S (2005). Bitter Fruit: The Untold story of the American Coup in Guatemala (revised version). Harvard University Press.

Welch HG, Schwartz LM, Woloshin S (2011). Overdiagnosed: Making People Sick in the Pursuit of Health.

Wing L (2005 Apr). Reflections on Opening Pandora’s Box. Journal of Autism and Developmental Disorders; 35(2): 197-203.

Competing interests: No competing interests

25 July 2019
Joel A Harrison
Long-Retired Epidemiologist
NONE: I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks
U.S.A.