“The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.”
Plato
Aribert Heim was a Nazi SS officer and physician whose infamy lies in the horrific ‘experiments’ he documented at Mauthausen Concentration camp during the year 1941. It is not for a lack of horror to Heim’s crimes that he lacks the name recognition of other Nazi physicians such as Josef Mengele. As Wikipedia says,
Jewish inmates were poisoned with various injections directly into the heart - including petrol, water and poison - in order to induce death more quickly
According to a former camp inmate, an 18-year-old Jewish youth came to the clinic with a foot inflammation. He was asked by Heim why it was that he was so fit. He replied that he had been a soccer player and swimmer. Instead of treating the prisoner’s foot, Heim placed him under anesthesia, cut him open, took apart one kidney, removed the second and castrated him. The boy was decapitated and Heim boiled the flesh off the skull so it could be displayed, the former inmate said.
Now the Wisenthal Center is engaging on a massive media campaign to flush out the 94-year-old Nazi war criminal. They seem to be convinced he is alive and in Chile. I heard an interview with a Wisenthal Nazi hunter actually in the South American country on NPR this morning and all of the major news outlets are covering the story.
The Simon Wiesenthal Centre believes Aribert Heim is in Patagonia, where his daughter is known to live.
The group has put up a 315,000 euros ($495,000; £250,000) reward for information leading to the arrest of Heim.
My only guess is they’re hoping the media coverage will force him to make a move; albeit a slow one I bet at ninety-four.
I would love to see Heim’s caught before he passes and escapes any accountability for his crimes.
I Spit My Green Beans Out As A Twelve Year Old And Ate A Whole Lot Of Meat
A little girl in Britain is sick, suffering from, amongst other things, rickets and several pathological fractures at the age of twelve years old. Such is the case because her parents have raised her on a strict vegan diet.
A 12-year-old girl in Scotland brought up by her parents on a strict vegan diet has been admitted to hospital with a degenerative bone condition said to have left her with the spine of an 80-year-old woman.
Doctors are under pressure to report the couple to police and social workers amid concerns that her health and welfare may have been neglected in pursuit of their dietary beliefs.
This wouldn’t be the first time that vegan parents were prosecuted for neglect. An infamous case in Georgia last year involved parents whose attempt at weaning their newborn along on a strict vegan diet led to his death and their life sentences. I’ll stay away from passing judgment on a specific case based on some blurb article in The Times. That said, it really is unacceptable to neglect children like this based on parental beliefs.
I’m drawing a line here admittedly. In the past I’ve been sympathetic to parents circumcising their children, I’ve supported the decisions of children young adults, who have reached a level of comprehension, to forgo medical treatment even when it appears clear their parents were influencing such a decision. Serving your child a strict vegan diet goes beyond that though. We’re discussing risk versus reward here and while you’d hate to have the government and society weighing every parental decision on such a scale in hindsight, there are things that clearly cannot be accepted.
What makes cases like this difficult is that we (or I at least) like to imagine negligence as something of lack of caring and lack of action. True, in vegan cases there is usually some of that. For instance, it is hard to imagine many of these children getting to the point they do if they had gone to recommended pediatrician visits. But, these aren’t parents trying to starve their children. They often come across as…well, moronic but not malicious.
That makes it tough, but it shouldn’t excuse it. We should expect parents to either know that such diets are bound to harm their children or, if uninformed about infant and children nutrition, to seek out information from reputable sources. Anything less has to amount to negligence, doesn’t it? Shouldn’t the state strive to protect its most hapless charges by reprimanding parents who harm their children by essentially starving them even if such isn’t through malice?
I think the answer has to be ‘yes’.
Not The Appropriate Path To Becoming A Physician
The above is an ad for americandreamabroad.com, which seems like a front to place Americans in a questionable medical school in China. Still a pretty funny ad.
via How To Split An Atom
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Photo: urbanwild/CC License
This is my second post on the ethics of organ transplantation today.
The story from the BBC goes like this: a dying 21 year old is an organ donor and the daughter of a mother who needs a kidney transplant. This young woman tries to target her kidney to her mother but instead, upon her death, the organs are allocated based on need.
Rachel Leake, 39, of Bierley, West Yorkshire, was told that her daughter Laura Ashworth’s dying wish to donate her organs could not be honoured.
The 21-year-old’s kidneys and liver went instead to three other patients.
Apparently there was some question as the daughter’s wishes, that she hadn’t expressed them formally. But the executor of the daughters last wishes, even in regards to her organs, should not be the organ donation sharing network…it should be her family. If this is policy then it is unacceptable and even if you cut it merely as a matter of miscommunication this is a really tragic.
Get This In Mexico, Get A Liver Transplant Here
Should illegal immigrants get transplants in the United States and should taxpayers pay for them? Discuss amongst yourselves.
Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the U.S. to seek medical care. She underwent two liver transplants at UCLA Medical Center as a child in 1989 and a third in 1998, each paid for by the state.
But when Puente turned 21 last June, she aged out of her state-funded health insurance and was unable to continue treatment at UCLA.
Now this young lady is getting a fourth transplant.
Here are the two arguments made, summed up in a sentence each. For restricting illegal immigrant access to organs,
“All transplants are about rationing,” said Roy Beck, executive director of NumbersUSA
For transplanting illegal immigrants,
“People are people, and when you make an incision in an organ donor, you don’t find little American flags planted on their organs,” [Dr. Michael] Shapiro said.
I’m torn by the issue. There really are two separate issues here and I think, despite some ethicists opinions to the contrary, that I can separate the two. From a bioethical standpoint, I think as long as we’re going to allocate organs through a central sharing process (and notice that I’m a long time supporter of targeted donation and actually a donor’s right to sell their organs) that such should be done on need and independent of citizenship or alien status. But I really don’t think, as in most instances, that tax dollars have any place supporting illegal immigrants.
Sovereignty is important. While their odds are no doubt much worse in their home countries that is where these illegal immigrants should be seeking their organ donations. Or they should be seeking legal immigration into this country.
A father catches the virus from his son in China. Such is what The Times is reporting, although I cannot find the case report in The Lancet Online which The Times cites. Yet. I suppose it might have a future publication date.
This is far from the first documented case of human to human transmission of bird flu, despite the Times’ health editor’s alarmist piece on the issue. There are cases of probable human to human transmission from at least 2005. I’m not sure what this specific case adds to the concern over easy human to human H5N1 transmission but it does come off another recent report of human to human transmission in Pakistan so I thought a brief bird flu update was in order.
Bright Red - Countries With Noted Avian H5N1 Infections
Dark Red - Countries With Noted Human H5N1 Infections
Lying In A Beach Chair Does A Number On Your Hips
This survey of British physicians was published in a British magazine a while back and I only now picked it up. In it a majority of respondants say that some care, apparently especially some operations, should be limited by patients’ age and lifestyles.
Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.
[…]
About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.
Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.
One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.
Tony Calland, chairman of the BMA’s ethics committee, said it would be “outrageous” to limit care on age grounds. Age Concern called the doctors’ views “disgraceful”.
That’s taking voluntary, transparent rationing to a pretty incredible level. When resources are scarce, as in most of medicine, then lifestyle can play a role in who gets what. I have no problem, along with 94% of British doctors in the survey, in saying an alcoholic who is likely to return to drinking shouldn’t be at the top of the liver transplant list.
Ninety-four per cent said that an alcoholic who refused to stop drinking should not be allowed a liver transplant…
Roger Williams, who carried out the 2002 transplant on the former footballer [George Best,] said doctors could never be sure if an alcoholic would return to drinking, although most would expect a detailed psychological assessment of patients, who would be required to abstain for six months before surgery.
But rationing based on age and some of the other suggestions put up in the survey just elicit a ‘yikes.’ Such transparent, open and flamboyant rationing efforts are inevitable in any limited global budget health care system (i.e. Britain’s socialized NHS).
h/t Grunt Doc
This Fundraiser Had A Very Cool African Drumming Group
I was at a fundraiser recently for a program to send several first years over to Ethiopia for 4-6 weeks. They had this interactive drumming group come in who are actually a lot of fun. And while I’ve been on some international mission trips, hearing the kids who did it last year talk it made me really wish I had gotten to do this in between my first and second year.
It is becoming a trend to get students far more involved in clinical experiences during their first two years. Indeed, my school may be a little slow to the party. But if you can find the funding for it, it seems very important to send first and second years on international experiences. Listening to the second years who had been last year, they were getting to operate with an incredible level of autonomy, see incredible things, in a small way help a lot of people. I’m sure all of them are better medical students and eventually better physicians, for their experience over there.
For the first years going this year, good luck and do some good over there guys.
This Frenchman Was The First Full Face Transplant Patient
The first full face transplant recipient has come froward a year after surgery.
“People in the street look at me very differently. They no longer stop and stare or shout cruel words.
“Instead I am accepted. I even dream of myself in my new face and now I would love to find a wife, settle down and have children.”
Multiple media websites are reporting this as Neurofibromatosis Type 1 (using either that name or the eponym Von Recklinghausen’s disease). While von Recklinghausen has some other disorders named after him and some MSM confusion might be expected, it appears from multiple news sources that this patient had NF1. A prominent feature of neurofibromatosis is multiple cutaneous tumors, but to get this big, start this early (at age 6), and to be “cured” by this face transplant seems unusual from my understanding.
Whatever the cause of the disfiguration, this is a remarkable result for the first patient to get his entire face replaced by a cadaveric donor.
The cost of health care has been and continues to rise dramatically in the United States. But only in the magnitude is the United States alone in the world with such a problem. A New York Times blush points out that,
The United States has long been an unusual study in medical care, with employers assuming much of the cost. Now, though, as the employers say “enough,” calls are deepening for the government to take on more of that role through nationalized health care.
The opposite situation is unfolding in other parts of the world. As long-running national health systems become overburdened, more employers are paying for workers’ supplemental health care costs.
According to the Watson Wyatt survey cited by the NYT piece, India’s employers will spend 30% more this year on health care than they did in 2007. That’s a one year increase. Canadian employers will spend 12% more than last year. Even British employers will spend 8% more than last year.
Granted in some of these countries these are percentage gains on what are relatively small expenses already, but it is still interesting and further circumstantial evidence questioning the sustainability of government run health programs with single budgets.
Punished…Or Sold
I’ve linked to stories concerning black markets for organs in the past. Now we get a story in the Los Angeles Times concerning such a market in Egypt. And it focuses around a terribly tragic story.
Hamed’s 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.
There was another way, one whispered about for those with nothing. A man could wager part of himself, slip into a hospital gown, and wake up with an incision above the gut.
Hamed sold a section of his liver for a bit more than the price of his son’s operation. The boy died in surgery.
With his scar healing and his son buried, Hamed, whose knowledge of anatomy would perhaps fill a single page, decided that driving a bus was not the fate of the man he wanted to be. He brokered his first liver deal four months ago. He earned $900. Four more sales have followed.
There are virtually no laws governing organ donations in Egypt. Or so the article makes it sound like.
Mohamed Queita, a member of the Egyptian parliament and the ruling National Democratic Party, has been working for 12 years to pass a law to regulate organ transplants and stop an expanding black market that draws patients from across the Middle East and as far away as Europe.
“It’s the worst kind of business in Egypt. It’s worse than slavery,” says Queita, who has no comprehensive statistics but notes that one Cairo clinic had a waiting list of 1,500 people willing to sell their organs. “I don’t want the poor turned into spare parts for the rich. . . . People are coming from all over to buy organs in Egypt. They’re mainly gulf Arabs. If you’re a rich man from the gulf, you go to a private Egyptian hospital that has contacts with organ brokers. Serious cases of poverty in this country are causing an increase in the theft and sale of organs.”
The emphasis is my own. This kind’ve paternalism is just wrong. There are terrible, horrific stories out there but no matter the motives or the life situation that forces someone into selling an organ, it seems something like such is a personal decision without any negative consequences for anyone else. The government has no place regulating such decisions.
It’s real simple - just let people do what they want with their bodies.
It isn’t like western societies’ bans on selling/buying organs are achieving their goals anyway. Protecting the poor? Maintaining some ‘equality’ in the distribution of limited organs? Nonesense.
You can’t make direct payments, but those with resources are still open to bettering their odds of getting an organ by doing everything just short of paying the previous owner of the organ.
Trepanations (putting a hole in someone’s skull) are the world’s oldest known surgeries, which is pretty fascinating when you think about it. There are skulls thousands of years old which actually show signs of healing after such operations, implying the patients survived the surgery.
Surgical Head Wound From The Iron Age
Well, we can add to the evidence of ancient neurosurgery. They’ve uncovered a young ancient Greek woman who appears to have had her head popped open after suffering some head trauma.
Site excavator Ioannis Graikos said the woman’s skeleton was found during a rescue dig last year in Veria, a town 46 miles west of Thessaloniki. “We interpret the find as a case of complicated surgery, which only a trained and specialized doctor could have attempted,” Graikos said.
A bone expert who studied the find said the skeleton belonged to a woman of up to 25 years old who had suffered a severe blow to the crown of her head, Graikos said. The operation was apparently an attempt to save her life.
He said the clearly defined shape of the hole left in the woman’s skull was a sign of relatively sophisticated surgery.
A doctor in England meets a man, takes a look at him, shakes his hand and becomes convinced the man has acromegaly.
It was nothing more than a warm handshake between two people meeting for the first time - but it was a gesture that saved Mark Gurrieri’s life.
The hand that clasped his belonged to a GP, Dr Chris Britt, who noticed a ‘fleshy and spongy’ feeling which instantly triggered his professional concern.
A glance at Mr Gurrieri’s large facial features all but confirmed his suspicions and set alarm bells ringing.
[…]
Dr Britt said: “As soon as I saw him I thought he looked like somebody who had acromegaly. When I shook his hand it felt fleshy, which is caused by the soft tissue being deposited.
“When I was a medical student I was at Barts Hospital in London where I saw a few people with the condition because it is a specialist centre for treating it. But it is extremely rare.”
Just an interesting story.
This is way off topic, but as a political buff I was rolling my eyes after running across this from Doris Lessing. The Noble laureate claims that Obama is bound to be assassinated if he’s elected president.
Obama, who is vying to become the first black president in US history, “would certainly not last long, a black man in the position of president. They would murder him,” Lessing, 88, told the Dagens Nyheter daily.
Okay, the woman is eighty-eight years old and her view is colored by time living in South Africa during Apartheid and such.
But I’ve laughed about Europeans’ view of race relations in America in recent years, and I think comments like this are a further example of the myopia plenty of Europeans have concerning world wide race relations.
As Europe deals with an incredible influx of immigrants from former colonial territories they’re seeing racial strife (or here) at least as significant as anything in the United States.
‘Hate crime’ is a loose term with vastly differing definitions in legislation by country, but it is incredible to note the per capita hate crime rates in the United Kingdom versus the United States. Europe is the new racial hot box (not that the United States doesn’t require continued work towards improving our own situation).
Doris Lessing probably needs to take account of the world she lives in nowadays and not that of her earlier years. Controlling for the increased number of firearms per capita in this country and America’s propensity for violence (i.e. American leaders in general are probably more likely to face assassination than most leaders of western Europe) the first African-American President is no more likely to be assassinated than the first black Prime Minister in the UK.
h/t Drudge
