27 September 2009

More soul searching

My “soul searching” post of Sept 17th prompted a whole set of interesting and valid comments, from a variety of viewpoints. All of which I've been mulling over with further soul searching. Replying to all of them, or even properly to one of them, would take more time than I can envisage ... so I'll pull just two of them and do my best in the few minutes available.

First up, Dr C (for whom I have nothing but respect and admiration) who said:

As for animal experiments, many drugs and treatments would never come to light without experimentation on animals.

I agree. And it's a powerful argument. I don't pretend to know what is right or wrong for others to decide, and I certainly do not judge others for deciding as Dr C suggests. I can only say that I would not (in the generalised abstract) decide that way myself.

One might make an analogy to the use of animals in farming and transportation. Certainly dragging a heavy plow around a field is not a horse's idea of fun. In fact, there would not be horse whips if this were true (or if horses ran races on a whim).

That is true; we can indeed make that analogy. However (again, for myself and not for anyone else) ... speaking philosophically ... since I see the horse as conceptually indistinguishable from me from Dr C, and since I would not harness Dr C up and make him haul a plough around a field nor carry me at speed while I whipped him (nor allow him to do the same to me), I could not use a horse in that way either. So the analogy still leaves Dr C and I on opposite sides of the same divide.

I think that we can make an argument for the use of research animals based on moral principals accepted by the majority.

Once again, I agree. And, as a society, we do. But the individual has a duty to act morally according to her/his conscience, and to decide when that requires dissent from the majority. If I do not recognise the conceptual difference between human and laboratory rat, then I cannot morally or ethically use a rat where I cannot morally or ethically use a human.

This leaves begging what I mean by "humanely".

Indeed ... another can of worms. (No, I won't follow a byway into the philosophy of worm rights at this juncture!)

To Geoff Powell I have no right to say very much. His viewpoint seems to be the same as mine, but I hang my head at the thought of claiming his lifetime of adherence in support of my easy, facile abstraction.

On the other hand, Geoff's point that a significant proportion of modern illnesses are iatrogenic is a valid one which sits alongside Dr C's reminder that our use of antibiotics has led to multiple resistance in the bacteria which they combat. However, the proposition that we have more disease now than we had before "modern medicine" is not one which seems defensible to me. Would I swap 2009 for 1909? No, I'm afraid I would not – which, of course, causes yet more anguished soul searching and self accusations of hypocrisy

Later additions:

On the iatrogenic issue, I agree with Ray Girvan that the putative link between polio vaccine and HIV is spurious. The MMR/autism controversy seems likely to go the same way on a balance of probabilities, although as yet it's less clear cut. Those specifics don't, though, invalidate the assertion that intervention does introduce a significant level of new problems (nor, incidentally, does iatrogenicity affect Geoff Powell's expressed preference for declining animal research based treatments). A quick search of medical literature published in the last twelve months for example, throws up almost a hundred papers mentioning iatrogenic hepatitis B or C. As I registered above, however, I do not think that a fair observer can claim an overall balance against medicine on functional grounds; my soul searching remains moral/ethical/philosophical.

On another front, in a side correspondence Matthew Revell raised the philosophical question of validity in an experiment where conceptual equivalence is denied. That's another road I haven't world enough or time to pursue here, but an intellectually intriguing one which is occupying a fair chunk of my mental "spare processing cycles time".

  • M Khurram et al, "Nephrogenic systemic fibrosis: a serious iatrogenic disease of renal failure patients", in Scandinavian Journal of Urological Nephrology. 2007; 41:565–56.

1 comment:

Dr. C said...

I admire your commitment to this issue in return. Concerning the MMR/autism link the role of mercury has been pretty much put to rest. One of the better summaries of this issue can be found in an essay by Dr. Harriet Hall entitled Vaccines & Autism. Dr. Hall frequently writes for the excellent blog Science-Based Medicine which appears to be fighting an uphill battle. Partially because of the furor about the MMR vaccine in England, the rate of vaccination for measles has declined and there have been outbreaks of that preventable disease, which can be fatal. Interestingly enough, the original research suggesting the Hg autism link has been found to be quite faulty.