nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Tuesday, June 22, 2010

Paternalism In Medicine: Taking Away Your Ability To Choose

Why do reformers talk about Patient-Choice, then form agencies to direct that choice?
I read an article that encapsulates a lot of what you read on Nostrums.  Readers know that I think medical care should be a choice that patients make in concert with their physician.  I'm suspicious of any government organizations that exist to funnel that choice into areas convenient for the government's intentions.

I'm derisive of nutritional laws that take toys from Happy Meals, and ban fast food restaurants in city districts that have few alternatives for dining, and dismissive of calorie labeling that has no impact on food choice.

While I think medical science should continue to define clinical guidelines for the best treatment in any given disease, I insist that each patient is unique and likely to need care that doesn't follow a formula.  Particularly one developed by a bureaucracy charged with "effectiveness"  (as in "comparative effectiveness").

So it was a pleasure to read the following paragraph from an article by Kenneth Minogue in the The New Criterion (June 2010).  Minogue is a political theorist and Emeritus Professor of Political Science at the London School of Economics.
"...while democracy means a government accountable to the electorate, our rulers now make us accountable to them. Most Western governments hate me smoking, or eating the wrong kind of food, or hunting foxes, or drinking too much, and these are merely the surface disapprovals, the ones that provoke legislation or public campaigns. We also borrow too much money for our personal pleasures, and many of us are very bad parents. Ministers of state have been known to instruct us in elementary matters, such as the importance of reading stories to our children. Again, many of us have unsound views about people of other races, cultures, or religions, and the distribution of our friends does not always correspond, as governments think that it ought, to the cultural diversity of our society. We must face up to the grim fact that the rulers we elect are losing patience with us."
"Our rulers are theoretically “our” representatives, but they are busy turning us into the instruments of the projects they keep dreaming up. The business of governments, one might think, is to supply the framework of law within which we may pursue happiness on our own account. Instead, we are constantly being summoned to reform ourselves."
Doesn't make me a libertarian.  I elect representatives to build that framework of law, not tell me what to choose.

Doc D

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