Biblical Reflections on Modern Medicine
Vol. 6, No. 1 (31)
Contents:
Christian, Do You Worship at the Altar of
Alternative Medicine?
or
"In the Day That You Eat from It, You Shall
Surely Die"
Jesus warned us, "Be in the world, but not of the world." Paul
directed, "Be not conformed to this world, but be transformed by the
renewing of your mind...." However, how many Christians will admit
that the world is a problem for them?
It seems that the influence of the "world" is subtle indeed. But,
then, the Prince of this world has been called an "angel of light."
And who does not want to be thought of as "en-light-ened?"
No, Jesus and Paul knew of the subtle, but powerful influence of
the world. They and many other passages in the Bible warn us of that
deception. However, we have great difficulty in thinking that we, as
individuals, have been duped. No, it's usually someone else who has
been duped.
Modern medicine is seen by many Christians as a deception. In
fact, that deception has been a major theme of my writing. Few have
been as critical and written the volume of work that I have against
modern medicine.
My own denomination, the Presbyterian Church in America, has
skyrocketing medical insurance costs (some pay $8000 per year)
because it has worshiped virtually everything that medicine has to
offer and tried to pay for it.
However, I have missed the root cause of this deception! I
was talking recently on the phone with a dear friend, lamenting the
growing movement of Christians to alternative medicine, which has no
more to offer in health or cure than orthodox medicine (except
possibly that it is safer and usually less expensive). He answered,
"The problem is that too many Christians are preoccupied with
health."
The proverbial light bulb went on. Of course! The fear of disease
and death is a strong part of our fallen human nature (I Corinthians
15:26, Hebrews 2:15). Few are so willing as Paul to boast in
weaknesses and give up beseeching God after three requests! (II
Cor.12:1-10)
Alternative Medicine Has Serious Problems
Since the publishing of my first book in 1985, I have gone on
public record as being open to medical means other than orthodox
medicine in which I was trained (Biblical/Medical Ethics,
pp. 110-111). In that same book, I severely criticized the lack of
efficacy in modern medicine (pp. 33-50). Until the September 1993
issue of Reflections, I had not attacked alternative medicine. I was
so close to orthodox medicine that its flaws were apparent, so I had
no axes to grind with alternative medicine.
However, I began to receive an increasing number of
advertisements from Christians making great claims about the
efficacy of various alternative remedies. While I have not spent my
time investigating them as I have orthodox medicine, many
similarities exist. For example, 1) Testimonials are insufficient to
establish a claim for cause and effect of a particular treatment. 2)
There is a science of human physiology that must be reconciled with
any treatment claim.
3) What works for one person does not always work for another. In
fact, what may heal one person may maim or kill another. 4)
Subjective feelings and results are difficult to make objective and
measurable.
Frankly, I get angry when letters or phone calls from Christians
imply that I am ignorant if I don't know the wonderful qualities of
such and such a treatment. Dear readers, I will compare my ability
to analyze science with almost anyone, especially in the time and
effort spent.
But, you see, those who make such claims have adopted irrational
thinking already and are blind to criticism. I am willing to state
that virtually any orthodox medical treatment has little to support
it and may be invalid. Are you willing to make that statement
about an alternative method?
If some Christians put as much time and effort into evangelism
and Bible study as they do in nutrition, exercise, and alternative
therapies, then the United States might not be as spiritually
bankrupt as it is!
The Problem Is Universal
I am fascinated that interest in alternative medicine exists
across all theologies from the thoroughly Reformed
reconstructionists to the more moderately Reformed to the broad
category of evangelicals to Pentecostals and primitive
fundamentalists. They are commonly deceived whether their theology
is detailed or elementary!
Again, I remain open that some of these alternatives may prove to
be beneficial therapies. However, the claims of their believers are
far beyond any proof of efficacy. Such therapies must be tested in
some objective manner, a difficult and expensive accomplishment.
The Problem Is Basic
As I stated above, the basic problem is a fear of death, a
prideful knowledge, and an unwillingness to grow through our
sufferings. This basic problem has prompted the modern miraculous
healing movement, as well. Again, the problem extends across all
theologies. Some anoint with oil. Some claim the gift of healing.
Some say that one only has to have "enough faith." Some claim that
Christians should never experience disease. Etc., etc.
The phone conversation with my friend tied it all together.
Whether it is modern medicine, alternative medicine, or miraculous
healing, the basic problem is fallen human nature -- the desire to
be healthy and not to suffer.
Please don't misread me. I am strongly in favor of alleviating
suffering and to heal where possible. I would encourage any and all
research (medical or alternative) to increase our ability to do
those things better. However, my experience in 25 years of medicine
and considerable reading on the experiences of other Christians is
that cause and effect in healing is close to impossible to "prove."
Most "proofs" are only suggestions. Most claims are excessive.
The bottom line that many may not want to accept is that we can
really count on very little (inside or outside of modern medicine)
to cure. Far and away, the best curative powers are those inherent
in the body that God has created (even in its fallen state) and
in a life that is obedient to God in a complete and consistent
manner (that excludes obviously harmful practices that harm the
body, e.g., smoking, drug abuse, and extreme obesity).
In spite of its gigantic problems, our best understanding and
hope relative to the understanding of disease and healing from
accidents lies with modern medicine. You know that too. Most
believers in alternative approaches and even miraculous healing seek
modern medicine when they get that squeezing chest pain of a heart
attack, are maimed in a car accident, find blood or pus coming from
bodily orifice, and discover other severe bodily malfunctions.
Don't worship at the altar of modern medicine, alternative
medicine, or miraculous healing. Worship instead at the altar of
the Triune and Sovereign God. He may choose to work through
one of the above or He may not. Hope and joy rest in Him and Him
alone.
Learn some humility about the difficulty of "proving" that any
treatment is beneficial. False claims are lies. Lying is a sin.
We may research, advertise, argue, or explore what we believe is
beneficial to health and healing. However, when we make excessive
claims, we are lying. "Bodily discipline (including health/medical
claims) is only of little profit, but godliness is profitable for
all things, since it hold promise for the present life and also for
the life to come" (I Timothy 4:8).
Environmentally Correct Foxholes
In case you have been worried about the military readiness of the
United States relative to recent news of under-funding, let me
assure you that there is -- more to worry about. Fort Gordon is a
large Army post in Augusta where I live. It is the primary training
headquarters for the Military Police of the U.S. Army. An article on
the front page of The Signal (its post newspaper) recently
caught my eye.
"'Where a unit digs its fighting positions is
(environmentally) important. If a commander wants to dig on the
side of a hill, we have to determine if that is really
necessary,' said Stephen Willard, Chief of the Environmental
Division." (Note that he holds no military rank.)
Thus, our fighting forces have to be environmentally correct
before considering military strategy. I suspect that this example is
only the tip of the iceberg of "politically correct" impositions on
the military. What military might the left has not stripped by
severe cuts in spending, they have compromised by political
correctness. Let us hope and pray that we don't have a real war any
time soon.
(Note: I hope readers will forgive momentary departures from
medical ethics such as this one. Some tidbits are just too juicy not
to pass along!)
Letter-to-Ed
Asking the New Congress to be Pro-life
Dear Dr. Payne,
Thanks for the good work. I would like to share some thoughts
about stopping abortion. With all the pro-life legislators, it could
be done this session. Here's how.
1. Encourage everyone to write their Congressman and Senator and
insist that they put a bill in the hopper on the first day of the
104th U.S. Congress. The bill would read essentially as follows:
A. Human life begins at conception and shall be afforded all the
protection of a person under the U.S. Constitution.
B. The Supreme Court is excluded from jurisdiction.
2. Encourage each legislator to send a letter to his colleagues
to sign as sponsors of the bill.
This bill would require only a 51% vote. If your "pro-life"
legislator won't do it, he really isn't serious about stopping
abortion. Publish the replies you receive. Expose the "talkers." If
they say it wouldn't pass, who knows? We must be faithful, not
"successful." And each one who refuses to do this, after being
informed, will himself be accountable for the death of each unborn
child from on.
They must do what they can or be held responsible. By introducing
such a bill, one absolves oneself from responsibility, whether
"successful" or not. And if we don't do what we can, i.e., write the
letters, we bear responsibility for the death of the unborn. We
can't do everything, but we can do something. I encourage you to
enter the battle at this level. May God grant us success, if it
please Him, but at least may we be faithful.
Yours by Sovereign Grace,
Lucius B. "Cap" Poser
Major, USAF (Ret.)
Brookhaven, MS
Ed's Note
I don't know if Mr. Poser's bill has the best wording or content.
For example, I am not sure that the Supreme Court can be excluded
from jurisdiction. If it can, are U.S. Districts courts any better?
Also, the first day of the 104th Congress has come and gone.
However, any day would be a good day to press the issue!
However, his letter does show how simple it could be for the
Congress to prove itself pro-life, even if it failed to pass such
legislation. There is no question that they need to have their feet
held to the fire on this issue!
Another Alternative to Health Insurance
I have previously reported on the Brotherhood Newsletter,
through which subscribers pay each other's medical bills. The cost
is much less than most insurance programs.
Samaritan Ministries International and its associated program,
the Christian Health Care Network, are similar ministries. Now,
founder Ted Pittenger has gone one step further with a plan
(Samaritan Associate Ministry) to cover pre-existing conditions
through the charity of their subscribers and other contributors. By
this mention, I am not endorsing their methods because I know too
little at this point. However, it seems worth investigating by those
readers who may be interested in medical coverage or helping with
the medical needs of other Christians.
For information, write: Samaritan Ministries International, P. O.
Box 413, Washington, IL 61571-0413 or call (309) 698-8765.
Immunization Paper Available
After receiving numerous requests about immunizing children, I
have written a paper that covers both general principles of health
and specific immunizations.
I recommend most immunizations and don't recommend others.
However, I address several issues that many enthusiasts may not have
considered. For example, if certain vaccines are unavailable in the
future, those not immunized could be at risk of exposure during an
epidemic of that disease. Also, immunization as one part of the
whole concept of health is a relatively minor issue. It is not the
major concern that enthusiasts have made it.
My paper is available to readers for the $2.00 cost of printing
and mailing. Although the copy that you receive may be passed
around, I do not want any copies made of the original. I welcome
your feedback as some conclusions are not entirely settled in my own
mind.
No Military Abortions - Domestic or Abroad
"It is now one and a half years since Clinton ordered
military physicians to start doing abortions. Every single
military doctor has relied on conscience causes. To date, there
has not been a baby killed by an elective abortion in any
military hospital, domestic or abroad...." (Life Issues
Connector, November 1994, p. 7)
Commentary: With the rapid turnover in military physicians and
the pressure on the military to provide abortions, this wonderful
fact may change. However, "G.I.'s for Truth," a pro-life group of
military physicians is fighting to keep their record intact.
Is There a Conscience in a Violent Alzheimer's
Patient?
I received a brief note from a reader with these questions. 1)
"Is there a conscience in a violent Alzheimer's patient?" 2) "Is
there such a thing as an inactive and an active conscience?"
These are excellent questions! Rather than write her
individually, I will answer them in the hope that I can dialog with
you readers. I will assume the second question in the context of the
first. Apart from organic disease of the brain, a conscience is
"active" or "inactive" according to the exercise of one's will. What
more can be said about it?
However, the conscience of an Alzheimer's patient is more
difficult. I am going to include all actions of Alzheimer's
patients, not just violent acts. The question of conscience is
applicable to all wrong behaviors of Alzheimer's patients. Also, I
will assume that Alzheimer's is a (more or less) correct diagnosis.
Alzheimer's disease is a specific diagnosis that has become a
"catch-all" term for many degenerative brain conditions.
The question might be better stated, "Does an Alzheimer's patient
know what he is doing?" If he has no consciousness of his actions
because of his disease, then his conscience is not "active" and
he should not be held accountable for his actions.
However, neither situations in life nor in medicine are at the
black and white extremes. It seems certain that Alzheimer's
patients' clarity of thought waxes and wanes with their disease
state. Their thinking may be crystal clear for a while and later
seem to lose virtually all touch with reality. So, how is one to
relate to Alzheimer's patients?
The Discipline of Children Is Applicable
To some extent, the discipline of children is applicable.
Children are learning reality, and right behavior has to be
enforced. However, the process in Alzheimer's patients is to retain
right behavior as long as possible, while expecting a downhill
course. With children, we expect right behavior to increase over
time.
As with children, we ought to err toward their understanding more
than might be apparent. Children understand far more than they are
able to articulate and may be held accountable beyond their verbal
ability to explain. Alzheimer patients should also. Many understand,
at least some of the time, what they are doing. As with children,
they will use lax attention and discipline sometimes as an
opportunity for wrong behavior.
Our deep caring may get in the way of what is best for the
Alzheimer's patient and his family. Allowing unrestricted behavior
may actually cause further deterioration, because the patient's
boundaries are further eroded and his orientation to reality becomes
more vague. One reviewer writes, "Any decision as to the rightness
or wrongness of conduct in a person declining into dementia should
ideally be made by the family. The family can overlook some
things in love. They can adjust expectations downward gradually.
Wrong acts which could also be criminal, e.g., assault, if
judged by the civil ruler, will be in a more rigid court in which
love and forbearance may have less, if any sway."
There is no doubt that the management of Alzheimer's patients is
more difficult than the management of children. Children's habits
are forming and their independence is limited. Alzheimer's patients
have deeply ingrained habits and decades of relative independence.
Often, the children are those who care for their Alzheimer's
parents, and parents don't want to be disciplined by their children.
"Is there a conscience in an Alzheimer's patient?" Yes, there is.
However, it may fade in and out. Management requires close
observation and attention to repetitive patterns. One ought to err
on the side of greater understanding by the patient than of less.
Such patients ought to be gently, but firmly, fenced in by expected
behavior.
Deterioration will occur. These patients may become impossible to
manage by behavioral methods alone. However, they ought be held
responsible for as long as is conceivably and physically possible by
those who care for them.
I would like to hear from you on this subject.
Perhaps, some physician readers have had considerable experience
with Alzheimer patients. Perhaps, some family members have
experimented with different approaches that have been successful.
Write and let me know.
The Paul Hill Dialogue
I have received a few more letters relative to the killings of an
abortionist and his escort by Paul Hill. I have chosen, however, to
leave the discussion as it appeared in the November 1994
Reflections. My purpose was to present both sides of the argument
and to stimulate readers to think beyond their initial response. If
there is an issue to which any letter-writer would like a personal
response from me, please write.
Since November, more killings have taken place, at an abortion
clinic in Massachusetts. However, it is clear that those killings
were not predicated upon the careful thought (whether right or
wrong) of Paul Hill. The more recent killings seem to be an
irrational response directed at no one in particular. No one
thinking rightly could begin to justify those killings.
Briefs and Commentary
India: 1948.
Underpopulated?
"In 1948, Jawaharlal Nehru wrote, 'I think India is an
underpopulated country.' He stated that some areas are indeed
heavily populated, but 'many parts are not populated at all.' (T.G.
Barnes, J.D. Feldman, editors: Breakdown and Rebirth, 1914 to
the Present, A Documentary History, vol. II, p. 201.) That
perspective runs counter to current thinking, and so we hear little
about it." (Chalcedon Report, November 1994, p. 44)
The After-life Will Not Be "Fun"
The following is the first sentence of the obituary of a man who
died of AIDS (acknowledged repeatedly by the paper).
"On Sunday, Brad, 38, went to start his new life, one that
will be filled with fun." (The Dallas Morning News,
December 7, 1994, p. 30A)
Commentary: While homosexuals and others may shake their fists in
God's face during their earthly lives, their lives in eternity will
not be "fun" if they persist to the end in this defiance. The "gay"
life is not "gay" either physically or spiritually, but it is "fun"
compared to eternity without God.
Mrs. Tony Campolo Endorses Sodomy
"'It had long been my prayer that a way would open for gay
and lesbian couples to publicly pledge their lives to each other
in both the church and the world.' (Thus, Mrs. Campolo)
described the wedding of two homosexual friends." (Baptist
Bulletin, December 1994, p. 33, reprinted from Dialogue
of the Brethren/Mennonite Council for Lesbian and Gay Concerns)
Note: The article wrote the ame as "Compolo." Campolo is the
correct spelling, as the identity of the person interviewed is
certain.
Commentary: I am not easily shocked. I often expect the worst of
people. However, I am shocked at this account, at evangelical
leaders groveling before Bill Clinton (Reflections, July
1994), at C. Everett Koop's support of the Clintons' agenda and
homosexuality, and at some books recently published by evangelical
book houses.
The last verse of Romans 1 is descriptive, "Although they know
the ordinance of God, that those who practice such things are worthy
of death, they not only do the same, but also give hearty approval
to those who practice them" (NASB). Without public disavowal, one
can only assume that Dr. Tony Campolo (her husband) also agrees with
her!
One of the great disappointments of my Christian life has been
such idiocy in Christians (some of whom I once held in great esteem)
over issues that seem crystal clear to me. Another disappointment is
the failure of spiritual growth in (what seems to be) the large
majority of Christians. But, then, I look at myself and at the
Bible, and I see the blindness of heart and the depth of evil
therein. We can only look up with the Publican and plead, "God be
merciful to me a sinner."
Human Stud Farms
Samuel Blumenfeld comments on the sperm bank located on
Massachusetts Avenue in Cambridge, Massachusetts, between Harvard
and Massachusetts Institute of Technology.
"The whole operation smacks of a stud farm. Some of these
students may father ten children or more who may want to know
some day who their father is. They may want to know who their
aunts and uncles are, who their paternal grandparents are. They
may want to claim inheritances. And if their fathers got
married, they may want to know who their half brothers and
sisters are. Can these student sperm donors claim no
responsibility for their offspring? When human beings take it
upon themselves to upset God's natural order, disorder will
result." (The Blumenfeld Education Letter, October
1994, p. 8. Address is P. O. Box 45161, Boise, ID 83711.)
Commentary: Dr. Blumenfeld has offered another strong argument
against artificial insemination by donor (AID). I have argued
Biblically against AID elsewhere, but Dr. Blumenfeld has graphically
described the violation of God's designed (preferable to "natural")
order.
A Challenge to Those Who Prescribe Birth
Control to Unmarried Women
Some who read this newsletter (and many beyond it) believe that
God blesses the prescription of birth control to unmarried women,
primarily because such prescriptions may prevent their aborting
later pregnancies. (They usually don't say that "God blesses" their
actions, but to say that what they do is right is to ask God to
bless it. "Rightness" and "God's blessing" are inseparably related
in a consistent Biblical ethic.)
To those believers, I ask, "Is it right to give sterile needles
to drug addicts to prevent HIV/AIDS?" To be consistent, they must
answer, "Yes." However, I suspect that a few will balk at this
extension of their logic. They will either wiggle around the dilemma
irrationally or they might just reconsider their position on birth
control!
Talking Back to Prozac:
A Book
Americans' (and presumably many Christians) love affair with
Prozac, a relatively new anti-depressant, needs a serious challenge.
That book is now available. I have not read it, but it seems to be a
counter-argument to all the "wonderful" claims of Prozac.
Talking Back to Prozac by Peter R. Breggin, M.D.,
published by St. Martin's Press, 273 pages, $19.95. Any book store
should be able to order it for you.
Further Incrimination of the Florida
Dentist Whose Patients Were Infected with AIDS
"The Florida dentist suspected of transmitting the AIDS virus
to six patients shared many traits with known serial killers and
may have committed "sexual homicide," according to research
reported in the journal, AIDS Patient Care. Dr. Leonard
Horowitz compared the personality of the dentist, Dr. David
Acer, who died of AIDS in 1990, with those of 36 sex-serial
killers studied by the FBI, and found similar profiles.
"Those traits and behaviors included social isolation, lack
of demonstrated emotion, chronic lying, anger, alcoholism,
pedophilia, physical fetishes, and a dependent and extremely
protective relationship Acer had with his widowed mother,
Horowitz said." (Chicago Tribune, October 12, 1994, p.
1)
Commentary: While "traits and behaviors" are not absolute cause
and effect, such descriptions are consistent with a dead conscience
which removes any moral restraint. I wonder, however, how many of
those characteristics apply to homosexuals in general, who are
deeply involved in that deviant lifestyle. Dr. Paul Cameron has
documented that 44 percent of "sexually-tinged mass murderers in the
United States from 1966-1983" were bisexuals or homosexuals, while
they comprise 1-3% of the population (The Gay Nineties,
Adroit Press, Franklin, Tennessee, 1993, p. 46)
Is American
Medicine a Free-Market?
Some argue that the free market is the problem rather than the
solution for the high cost of medical care . Readers of this
newsletter are not as likely as others to be confused over this
point. (I hope!) However, you may want some brief specifics.
1) Orthodox medicine has a monopoly on medical practitioners
through state licensure. If you don't believe me, just hang out a
shingle to practice medicine or nursing without a state license and
see how long you last. State licensure strictly limits who practices
the medical arts.
2) State insurance laws are costly. State regulations strictly
limit what medical policies can offer, who may offer them, and what
may be covered. This area is partially an extension of licensure.
Only licensed practitioners are eligible for compensation. Also,
there are risk pools that are assigned to insurance companies. That
is, they have to take certain people who are high-risk for large
expenses and who are otherwise uninsurable. Their costs must be
borne by the other policy holders.
3) The Food and Drug Administration (federal) strictly limits
both the available drugs and what they may claim to do. The time to
get approval for a drug and the research necessary to "prove" its
efficacy makes a drug or device's eventual cost to be considerable.
4) Federal money is granted for research of medical treatments.
While virtually everyone is for research to develop the "latest and
best" treatments, this money has allowed a rapid growth of
technology. Once developed, no hospital or physician would dare not
be without this "latest and best," so it is added at great cost to
the patient through his pocket, insurance, or government payer.
These items rarely improve patients' quality of care or cure rate.
5) Federal and state programs have been created with few
limitations on the medical services made available to recipients.
The largest programs are Medicare and Medicaid. Medicaid is now the
largest item in some state budgets. This tremendous amount of money
further inflates the system in terms of resources needed and a
demand that drive prices up.
6) State and federal regulations on hospitals are expensive.
Under federal mandate, emergency rooms cannot turn away any person
who presents for treatment. Hospitals have to meet special policies,
equipment, and procedures under the Occupational and Safety Act
(OSHA) and other federal, state, and local regulations.
There are others, but these should be sufficient to close the
case that American medicine is light years away from a free market.
These costs inflate medical care costs several-fold over what they
would otherwise be. The bottom line is that the more government at
any level is involved in (i.e., controls), the more that it will
cost and the poorer the quality of services that will be provided.
The only "health-care bill" that ought to be acceptable to the
Americans is one that has the government getting out of medicine.
AIDS: Issues and Answers
Vol. 9, No. 1 (56) January 1995
Should Expectant Mothers Be Tested for
HIV?
"Should Expectant Mothers Be Tested for HIV?" This question was
asked in Christianity Today (December 12, 1994, p. 68). The
question arose because of a report in The New England Journal of
Medicine (November 3, 1994, pp. 1181-1187) that giving
zidovudine (AZT) to pregnant women with the AIDS virus (HIV) reduced
by two-thirds the transmission of that infection to their babies.
The question was asked of two secular ethicists (Drs. Arthur
Caplan and Ruth Macklin), the president of Americans for a Sound
AIDS Policy (Dr. Shepherd Smith), a theologian (Dr. Harold O. J.
Brown), a policy analyst of the National Association of
Evangelicals, the director of Care Center Services for Care Net
(Richard Cizik), and other "leading spokesmen" (Ed's term) of
various groups.
While some valid points about testing per se were raised, no
one suggested that the study ought to be studied for its reliability
and applicability! If the study is seriously flawed, the
question asked becomes moot!
In medical school, we took a short course based upon the book
How to Lie with Statistics. As residents, we occasionally had
discussions with a statistician who would dissect medical research
articles. When he finished, we often wondered how we could practice
medicine at all will such flaws in all medical studies.
Everyone should first be a skeptic about any new medical finding,
especially when great fanfare surrounds its announcement to the
world!
You, reader, can do this yourself. How many times on the evening
news have you seen an exciting new treatment for cancer? Perhaps,
you have heard such "breakthroughs" once a week. But, even if they
were only monthly, don't you think we would be well on our way to
winning the war on cancer, if such reports were truly valid?
Another reason to be skeptical was stated by an editor in the
same issue of the Journal in which that research appeared.
Dr. Ronald Bayer described a "bleak clinical picture that has
surrounded AIDS, especially since the report that the early use of
AZT in HIV infection (in men and non-pregnant women) had no apparent
effect on clinical outcome." In other words, the most heralded cure
(AZT) for HIV/AIDS had been shown to have little or no benefit. The
AIDS gurus needed a dramatic study to bolster their demand that
HIV/AIDS patients be given special treatment in the medical world.
Christians worship at the altar of medical science. I have
repeatedly said that the greatest stumbling block for Christians to
assess properly the role and cost of modern medicine is its lack of
effectiveness. If something does not reliably work, why debate
whether it should be made available at all? (Christians also worship
at the altar of alternative medicine! See front
page.)
Problems with AZT
in Preventing Mother-Child Transmission of HIV
First, let's look at the numbers. The study reported a 67.5%
reduction in transmission of HIV. There were 199 babies tested for
HIV after one year of age. Of those who acquired HIV from their
mothers and tested positive for HIV after birth, 7 (7.3%) were in
the AZT-treated group (total of 95) and 20 (19.2%) in the placebo
group (total of 104). Note that 84 babies (80.8%) of the babies in
the placebo group were not infected! AZT was not needed for these
babies, as natural and unknown factors prevented HIV transmission
from their mothers.
Thus, the reality is that AZT prevented transmission of HIV in
11.9% of babies treated. That is, 1/8 benefited from the AZT while
7/8 did not! So, 7 of 8 receive a highly toxic drug to prevent
transmission in 1 of 8. So, the question is whether it is ethical to
treat 7 of 8 babies to affect 1 in 8? If the merits of this study
are proven over time (a big if -- see below), then that is a
question for parents, not physicians.
Second, there are major flaws in the study that are glossed over.
There were 8 fetal or neonatal deaths, 5 in the AZT group and
2 in the placebo group. However, the conclusion of the study is that
"None of these deaths were attributable to the study drugs." Oh,
yeah? I don't think that these deaths can be so easily discounted.
Third, the study began with 477 pregnant women with 409 giving
birth to 415 live infants with 363 infants actually tested for
HIV-status sometime after birth. Only 199 were tested beyond one
year of age. So, the numbers for various reasons were reduced from
477+ babies (allowing for twins, etc.) to 199 tested at the end of
the study. Since only 27 babies actually tested positive after one
year from the starting number of 477+, the positives are a only a
small fraction of the whole. Such a small fraction is easily
susceptible to falsely skewed numbers.
I have only scratched the surface on the possible flaws in this
study, but space limits further analysis. Perhaps, however, you can
begin to see that this study has problems inherent in the study
itself.
From the beginning of AZT treatment results in adult AIDS
patients, I was skeptical of its efficacy. Over several years, the
"experts" proved my position. This study of transmission of HIV from
mothers to infants has more significant numbers than those earlier
studies. However, I am not convinced that the accuracy of this study
will stand.
Perhaps, some efficacy will eventually be demonstrated, but when
treatments are applied in everyday clinical situations, the tightly
controlled parameters of a research study are lost and the
likelihood of the same results found in the original study are nil.
The question that should be asked is, "Should thousands of unborn
babies be subjected to a toxic drug on the basis of one study which
almost seems designed to show its intended results?" That answer is
not clear. |
